Continuous Glucose Monitoring Systems: Are They Useful for Evaluating Glycemic Control in Children with Hyperinsulinism?

Arpana Rayannavar, Okan U. Elci, Lauren Mitteer, Diva D. De León

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


BACKGROUND: Effective treatment and close monitoring in children with congenital hyperinsulinism (HI) are important to prevent hypoglycemic-associated brain damage. The current monitoring approach involves measuring plasma glucose intermittently, but this does not provide a comprehensive assessment of glycemic control and may fail to detect episodes of hypoglycemia.

OBJECTIVE: To determine whether Dexcom G5®, a continuous glucose monitoring system (CGMS), is an accurate and effective method for monitoring glycemic control in children with HI.

METHODS: Cross-sectional, observational study in 15 children with HI. Participants wore a blinded Dexcom G5® device for 2 weeks. At the end of 2 weeks, data from the Dexcom G5® and home glucose meter were downloaded and analyzed.

RESULTS: Fourteen children (15-67 months) completed the study. Using Bland-Altman analysis, the mean (SD) difference between 1,155 paired CGM and glucose meter readings was -8.09 (53.76). The sensitivity and specificity of CGM to detect hypoglycemia (<70 mg/dL) were 86 and 81.4%, respectively. The positive predictive values for hypoglycemia and severe hypoglycemia (<54 mg/dL) detected by CGM were low (50.3 and 14.8%, respectively), while the negative predictive values were high (96.4% for glucose <70 mg/dL and 99.1% for glucose <54 mg/dL).

CONCLUSION: Our study showed that CGM is not a reliable method to monitor for hypoglycemia, given the high number of false positive hypoglycemia readings. However, CGM can be useful in preventing unnecessary checks by glucose meter during times of normoglycemia. Therefore, the benefits of using CGM in patients with HI would be in guiding the need to check plasma glucose by glucose meter rather than point accuracy.

Original languageEnglish (US)
Pages (from-to)319-327
Number of pages9
JournalHormone Research in Paediatrics
Issue number5
StatePublished - Apr 1 2020
Externally publishedYes

Bibliographical note

Funding Information:
Arpana Rayannavar, Okan U. Elci, and Lauren Mitteer have no conflicts of interest to disclose. Diva De Leon consults for Zealand Pharma A/S, Crinetics, Novartis Pharmaceutical Corporation, and Soleno Therapeutics. She has also received research funding from Zealand Pharma A/S and Crinetics.

Funding Information:
This project was funded by Zealand Pharms A/S. Dexcom Inc. provided the devices used in this study. Fellowship support to Arpana Rayannavar from NIH-T32DK063688-16.

Publisher Copyright:
© 2019 S. Karger AG, Basel. Copyright: All rights reserved.


  • Blood glucose
  • Continuous glucose monitor
  • Glucose meter
  • Hyperinsulinism
  • Hypoglycemia
  • Cross-Sectional Studies
  • Blood Glucose/metabolism
  • Humans
  • Child, Preschool
  • Hyperinsulinism/blood
  • Infant
  • Male
  • Brain Injuries/blood
  • Monitoring, Physiologic
  • Female
  • Hypoglycemia/blood
  • Child

PubMed: MeSH publication types

  • Clinical Trial
  • Observational Study
  • Journal Article


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