Trial reportArchives of disease in childhood. Fetal and neonatal edition2020
Feasibility of automated insulin delivery guided by continuous glucose monitoring in preterm infants.
Trial report in Archives of disease in childhood. Fetal and neonatal edition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Continuous glucose monitoring for the prevention of morbidity and mortality in preterm infants.The Cochrane database of systematic reviews · 2021Pooled it
- Continuous glucose monitoring for the prevention of morbidity and mortality in preterm infants.The Cochrane database of systematic reviews · 2020Pooled it
- Real-time continuous glucose monitoring in preterm infants (REACT): an international, open-label, randomised controlled trial.The Lancet. Child & adolescent health · 2021Trial
- Neurobehavioral outcomes at 12 months in very preterm infants monitored with continuous glucose monitoring at birth compared with full-term infants.Scientific reports · 2026Article
- Task-free functional connectivity changes before and after hyper- and hypoglycemia in very preterm neonates.Neurophotonics · 2026Article
- Case Report: Subcutaneous sensor-augmented insulin pump therapy in a 510-g preterm infant with hyperglycemia.Frontiers in pediatrics · 2026Article
- The neonatal continuous glucose monitoring paradox: why at-risk infants still lack access to a transformative technology-A call for needs-led innovation.Frontiers in medicine · 2026Article
- Treatment of Severe Hyperglycemia in Extremely Preterm Infants Using Continuous Subcutaneous Insulin TherapyJournal of clinical research in pediatric endocrinology · 2024Article
- Impact of macronutrients intake on glycemic homeostasis of preterm infants: evidence from continuous glucose monitoring.European journal of pediatrics · 2024Article
- Evidence from clinical trials on high-risk medical devices in children: a scoping review.Pediatric research · 2024Article
- Hyperglycemia and prematurity: a narrative review.Pediatric research · 2023Review
- Continuous Glucose Monitoring in the Intensive Care Unit.Journal of diabetes science and technology · 2023Article
- Accuracy to detect neonatal hyperglycaemia using real-time continuous glucose monitoring during postoperative period.European journal of pediatrics · 2023Article
- Continuous glucose monitoring for children with hypoglycaemia: Evidence in 2023.Frontiers in endocrinology · 2023Review
- Should continuous glucose monitoring be used to manage neonates at risk of hypoglycaemia?Frontiers in pediatrics · 2023Review
- Management of Neonatal Diabetes due to aCase reports in endocrinology · 2023Article
- Experience with enteral sulfonylurea monotherapy for extremely low birth weight infants with hyperglycemia.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2022Article
- Hyperglycaemia in the Newborn Infant. Physiology Verses Pathology.Frontiers in pediatrics · 2021Review
- Open-Source Technology for Real-Time Continuous Glucose Monitoring in the Neonatal Intensive Care Unit: Case Study in a Neonate With Transient Congenital Hyperinsulinism.Journal of medical Internet research · 2020Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectiveClosed-loop systems have been used to optimise insulin delivery in children with diabetes, but they have not been tested in neonatal intensive care. Extremely preterm infants are prone to hyperglycaemia and hypoglycaemia; both of which have been associated with adverse outcomes. Insulin sensitivity is notoriously variable in these babies and glucose control is time-consuming, with management requiring frequent changes of dextrose-containing fluids and careful monitoring of insulin treatment. We aimed to evaluate the feasibility of closed-loop management of glucose control in these infants. DESIGN AND
settingSingle-centre feasibility study with a randomised parallel design in a neonatal intensive care unit. Eligibility criteria included birth weight <1200 g and <48 hours of age. All infants had subcutaneous continuous glucose monitoring for the first week of life, with those in the intervention group receiving closed-loop insulin delivery in a prespecified window, between 48 and 72 hours of age during which time the primary outcome was percentage of time in target (sensor glucose 4-8 mmol/L).
resultsThe mean (SD) gestational age and birth weight of intervention and control study arms were 27.0 (2.4) weeks, 962 (164) g and 27.5 (2.8) weeks, 823 (282) g, respectively, and were not significantly different. The time in target was dramatically increased from median (IQR) 26% (6-64) with paper guidance to 91% (78-99) during closed loop (p<0.001). There were no serious adverse events and no difference in total insulin infused.
conclusionsClosed-loop glucose control based on subcutaneous glucose measurements appears feasible as a potential method of optimising glucose control in extremely preterm infants.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.