title: Continuous glucose monitoring and retinopathy of prematurity.
abstract: OBJECTIVE
  To use the continuous glucose monitoring system (CGMS) in very low birthweight (VLBW) infants to further explore the association between elevated glucose levels and retinopathy of prematurity (ROP) and to find new preventive strategies for ROP.
  
  
  METHODS
  A secondary analysis of risk factors for ROP in VLBW infants was performed in the neonatal intensive care units of University Hospital Leuven and ZOL Genk, Belgium. The subjects were part of the NIRTURE trial (ISRCTN78428828). Only control subjects with conclusive ROP assessments who received standard clinical care were included in this analysis. A total of 100 VLBW infants (birthweight = 1500 g) were included. Twenty-three (23%) infants developed ROP; 77 (77%) did not.
  
  
  RESULTS
  Development of ROP was linked to the known classic risk factors. In addition, ROP was associated with higher glycemia levels across the first week (p between 0.01 and <0.0001). Across the first week, glycemia predicted ROP with receiver operating characteristic (ROC) scores between 0.67 and 0.80, and with a median glycemia cutoff of 6.7 mmol/L. Comparison of ROC curves revealed first-week glycemia as an important variable in the development of ROP with a predictive power as high as the classic risk factors.
  
  
  CONCLUSIONS
  Moderately elevated glucose levels in the first week of life are associated with the development of ROP. They contribute to this multifactorial disease in a way equal to the known classical risk factors for ROP. Therefore, careful monitoring of glucose levels by CGMS can be helpful in the prevention of ROP.
authors.affiliation: Neonatal Intensive Care Unit, University Hospital Leuven, Leuven, Belgium. sophie.vanhaesebrouck@uzleuven.be
authors.forename: Sophie
authors.initials: S
authors.lastname: Vanhaesebrouck
authors.forename: Christine
authors.initials: C
authors.lastname: Vanhole
authors.forename: Claire
authors.initials: C
authors.lastname: Theyskens
authors.forename: Ingele
authors.initials: I
authors.lastname: Casteels
authors.forename: Johan
authors.initials: J
authors.lastname: Maleux
authors.forename: Karel
authors.initials: K
authors.lastname: Allegaert
authors.forename: Gunnar
authors.initials: G
authors.lastname: Naulaers
authors.forename: Hans
authors.initials: H
authors.lastname: Daniëls
authors.forename: Francis
authors.initials: F
authors.lastname: De Zegher
mesh_terms: D001530:Belgium / Q000453:epidemiology; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood*; D007363:Intensive Care Units, Neonatal; D008297:Male; D008991:Monitoring, Physiologic; D012372:ROC Curve; D012178:Retinopathy of Prematurity / Q000097:blood* / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D001786:Blood Glucose