Intraday glucose fluctuation is common in preterm infants receiving intermittent tube feeding.
BACKGROUND
We previously reported on three preterm infants with blood glucose abnormalities after reaching full enteral feeding. Recently, it has been shown that clinically stable preterm infants may have large fluctuations in blood glucose after the establishment of enteral nutrition. We hypothesized that intraday glucose fluctuation is a common finding in preterm infants, but improves at term post-conceptual age. This report describes a case series.


METHODS
From June 2010 to July 2012, 13 preterm infants (29.5 ± 2.1 post-conceptual weeks, 1144 ± 319 g) were enrolled in this study. Continuous glucose monitoring (CGM) was conducted on average at 33.5 ± 1.4 post-conceptual weeks, when they received gastric tube feeding every 3 h in the absence of i.v. glucose supply.


RESULTS
Eight infants (62%) had large intraday glucose fluctuation with repeated hyperglycemic (>150 mg/dL) and hypoglycemic (<50 mg/dL) events. In five infants, follow-up CGM at 36-38 weeks post-conceptual age showed more stable glycemic changes without any abnormal glucose levels.


CONCLUSIONS
On CGM, in some preterm infants intermittent tube feeding resulted in large intraday glucose fluctuation at 31-35 post-conceptual weeks, but the pattern disappeared before discharge (36-38 post-conceptual weeks).
Department of Pediatrics, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
Hiroshi
H
Mizumoto
Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Masahiko
M
Kawai
Department of Pediatrics, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
Sumie
S
Yamashita
Department of Pediatrics, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
Daisuke
D
Hata
D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D004750:Enteral Nutrition / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D007441:Intubation, Gastrointestinal; D008297:Male; D008991:Monitoring, Physiologic; D017063:Outcome Assessment, Health Care
D015415:Biomarkers; D001786:Blood Glucose
continuous glucose monitoring; glucose fluctuation; hyperglycemia; hypoglycemia; preterm infant