ECEESPE2025 Poster Presentations Diabetes and Insulin (143 abstracts)
Evaluation of the performance of continuous glucose monitoring in the treatment of patients with congenital hyperinsulinism
Laura Sayol Torres 1 , Ariadna Campos-Martorell 1 , Cristina Aguilar Riera 1 , Gloria Gomez Yepes 1 , Natàlia Romaní Franquesa 1 & Maria Clemente Leon 1
1Hospital Universitari Vall d’Hebrón, Barcelona, Spain
JOINT1539
Introduction: Continuous glucose monitoring (CGM) is a promising but unvalidated tool for the management of patients with congenital hyperinsulinism (CHI).
Objective: To assess the accuracy and performance of CGM in the management of patients with CHI.
Patients and Methods: Monocentric, retrospective, observational and analytic study. Inclusion criteria: patients diagnosed with CHI using CGM in hospital and/or outpatient settings. Data collection was conducted through medical record reviews and sensor downloads. For hospitalized patients, blood glucose measurements (BGM) were taken every 2-8 hours (depending on the clinical condition); the measurements performed to verify extreme sensor values were also recorded. For outpatients, BGM for hypoglycaemia-checking or calibration were collected. Only paired measurements taken within 3 minutes or less were included. Pairs performed to confirm the resolution of hypoglycaemic episodes were excluded. Families were surveyed regarding their experience with CGM. Statistical analysis was performed using XLMiner Analysis ToolPak.
Results: Data from two years of follow-up (2022-2024).
| CGM | Patient | Age (months) | n of pairs of data | Origin |
| Dexcom G6 | P1 | 2 | 45 | Hospitalized |
| 1 | Outpatient | |||
| P3 | 61 | 3 | Outpatient | |
| P4 | 35. 2 | 17 | Outpatient | |
| P5 | 0. 67 | 87 | Hospitalized | |
| P6 | 41. 4 | 1 | Outpatient | |
| P7 | 149. 6 | 13 | Outpatient | |
| P8 | 26. 4 | 58 | Outpatient | |
| Dexcom G7 | P2 | 0. 56 | 33 | Hospitalized |
| Libre2 | P3 | 61 | 27 | Outpatient |
| P9 | 96. 6 | 62 | Outpatient | |
| Total | Median/IQR 35. 2/59 | 347 | 165 Hospitalized 182 Outpatient | |
| Pearson’s correlation test | R | p | n of pairs of data | |
| Total | 0. 94 | <0. 05 | 347 | |
| Glucose ≤70 mg/dl | 0. 20 | 0. 02 | 124 | |
| Glucose ≤50 mg/dL | -0. 24 | 0. 31 | 20 | |
| MARD | % | n of pairs of data | ||
| Total | 16. 1 | 347 | ||
| Glucose <70 mg/dl (all sensors) | 14. 4 | 115 | ||
| Libre2 (all glucose values) | 11. 7 | 89 | ||
| Libre2 (Glucose <70 mg/dl) | 17. 1 | 16 | ||
| Dexcom G6 (all glucose values) | 15. 6 | 278 | ||
| DexcomvG6 (Glucose <70 mg/dl) | 13. 7 | 107 | ||
| Hypoglycaemia detection (≤70 mg/dL): CGM identified 124 episodes, of which 91 were confirmed by capillary glucose (Sensitivity=79. 1%, Specificity=85. 8%, PPV=73. 4%, NPV=89. 2%). All hypoglycaemia episodes ≤50 mg/dL were detected with a minimum CGM threshold of ≤65 mg/dL (Sensitivity=100%, Specificity=74. 4%, PPV=7. 5%, NPV=100%). All participants reported satisfaction with CGM use and declined its removal. | ||||
Discussion/Conclusions: CGM effectively prevents severe events and facilitates real-time decision-making in CHI patients. A CGM glucose threshold of 65 mg/dL is proposed, requiring capillary confirmation for values ≤65 mg/dL. Trend arrow analysis may optimize this, posing a goal for future studies.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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