ESPE Abstracts

Background: Continuous glucose monitoring (CGM) devices are novel tools to measure the impact of dietary intake on glucose rhythms/metabolism in children. There is a significant gap in the literature on glycemic response in healthy, term infants and young children up to 2 years of age.

Objective: To investigate glucose excursions in response to infant feeding, using CGM in healthy 6–12-month-old infants.

Methods: An observational, non-intervention exploratory study was conducted in healthy, full-term 6–12 month-old infants. Continuous glucose measurement with the "FreeStyle Libre® Pro" (Abbott® Diabetes Care, Witney, Oxon, UK) device was performed over 5 days. We analyzed key glycemic parameters including incremental area under the curve, (iAUC), incremental maximal glucose value (iCmax), time to reach this value (Tmax)) as well as the correlation between macronutrient consumption and interstitial glucose fluctuations.

Results: Out of 54 infants screened, 10 infants were recruited (50% females). Mean age was 10.2 ± 1.5 months, weight (mean z-score 0.26 ± 1.08) and height (mean z-score 0.97 ± 1.27) were all within normal ranges. No serious adverse events were observed while on CGM. In total, 70% of glucose values were within the normal range (3.5 – 5.5 mmol/L) while 10% measured 5.5 – 10 mmol/Land no values were >10 mmol/L. Notably, 20% were <3.5 mmol/l with 11% falling below 3.0 mmol/L. Feeding occasions containing >30g carbohydrate (mid-day, afternoon and evening) induced higher 2h-iAUC (respectively 3.42, 3.41 and 3.50 mmol/L*h) than the two morning feeds that contained <25g carbohydrates (with iAUC respectively 2.72 and 2.81 mmol/L*h) (P<0.05). Feeding occasions including high fat content induced larger Tmax values. The difference between glucose values before each excursion and the fasting glucose value (3.34 ± 0.55 mM) increased significantly during the day: from 0.24 ± 0.39 mM in the early morning to 1.07 ± 0.57 mM in the evening (P<0.05).

Conclusions: Our proof-of-concept study demonstrates the feasibility of using CGM in infants aged 6–12 months old. The observed circadian rhythm and range of glucose values identified may highlight the need for a deeper understanding of metabolic adaptations to nutritional intake in early life.