BabyGlucoLight - Impact of blood glucose variability on the very preterm neonatal brain

Preterm neonates do not have a developed control of the levels of blood sugar, since this control develops during the last trimester of pregnancy. During the first week of life, therefore, they could experience episodes of high or low levels of blood sugar, defined hyperglycemia and hypoglycemia, respectively. Blood sugar levels should be kept as constant as possible within a predefined interval, since hypo- and hyperglycemia have been associated with increased mortality and impaired neurodevelopmental outcome. The standard of care to monitor blood sugar levels consists in point-of-care measurements, usually twice a day, hence, hypo- and hyperglycemic episodes might go unnoticed for several hours. A possible solution would be to continuously monitor blood sugar levels. This procedure would require inserting a device with a needle in the baby’s thigh. Recent studies demonstrated that this device can be safely used in the preterm population, reducing the number of hypo- and hyperglycemic episodes compared to standard therapy. The link between hypo- and hyperglycemia and possible brain damages is, however, still largely unexplored, since it is extremely difficult to monitor in real-time the brain’s health in preterm neonates in intensive care unit.

The BabyGlucoLight project aims, first, to investigate the link between hypo- and hyperglycemic episodes and the brain’s response to these events. Second, this project aims to evaluate the impact on brain development of knowing in real-time the blood sugar levels compared to standard point-of-care measures. These aims were tackled using a non-invasive neuroimaging technique, which uses light to measure cerebral signal. For the first time we applied this device, which consists in a swim-like cap that should be wear on the baby’s head, on the preterm population.

We performed a long-term continuous monitoring of the brain signal during the first week of life. Twenty-six preterm neonates were recruited, and their brain and blood sugar levels were continuously monitored. The measured data will help us to highlight the link between these two variables, aiming to improve neonatal therapies and the baby’s neurocognitive development.