pediatricjournalАрхив педиатрии и детской хирургииArchives of Pediatrics and Pediatric Surgery2949-46643033-6783НИКИ детства Минздрава Московской области10.66825/2949-4664-apps-4-2-79-89pediatricjournal-283Research ArticleОБЗОРЫREVIEWSНепрерывный мониторинг гликемии у новорожденных: современные подходы, технологии и клиническое значениеContinuous glucose monitoring in newborns: current approaches, technologies and clinical relevancehttps://orcid.org/0000-0003-4757-5576АксеновД. В.AksenovD. V.

Аксенов Денис Валериевич, заведующий отделением патологии новорожденных и недоношенных детей, Балашихинский родильный дом; научный сотрудник Научно-исследовательского клинического института детства Министерства здравоохранения Московской области; ассистент кафедры детских болезней факультета усовершенствования врачей, Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского

143985, Московская обл., г. Балашиха, мкр-н Саввино, Саввинская ул., д. 15

129110, г. Москва, ул. Щепкина, д. 61/2

Denis V. Aksenov, Head of the Department of Pathology of Newborns and Premature Infants, State Budgetary Healthcare Institution of the Moscow Region «Balashikha Maternity Hospital»; researcher of the GBUZ MO «Scientific and Research Clinical Institute of Childhood of the Ministry of Health of the Moscow region»; Assistant of the Department of childhood diseases of the Faculty of Advanced Training of Doctors, State Budgetary Healthcare Institution of the Moscow Region «Moscow Regional Research Clinical Institute named after M. F. Vladimirsky»

15 Savvinskaya str., mkr. Savvino, Balashikha, 143985

Bldg. 1, 24a Kominterna str., Mytishchi, 141009

61/2 Shchepkina str., Moscow, 129110

aksens77@mail.ruhttps://orcid.org/0000-0001-6395-0407КондратьеваЕ. И.KondratyevaE. I.

Кондратьева Елена Ивановна, д.м.н., профессор, руководитель научно-клинического отдела муковисцидоза, заведующая кафедрой генетики болезней дыхательной системы, заместитель директора по научной работе ФГБНУ «Медико-генетический научный центр им. акад. Н.П. Бочкова»

141009, Московская обл., г. Мытищи, ул. Коминтерна, д. 24а, стр. 1

15522, г.Москва, ул. Москворечье, д. 1

Elena I. Kondratyeva, Dr. Sci. (Med.), Professor, Head of the Cystic Fibrosis Research and Clinical Department, Head of the Department of Respiratory Disease Genetics at Research Centre for Medical Genetics; Deputy Director for Research, Research Clinical Institute of Childhood of the Moscow Region

Bldg. 1, 24a Kominterna str., Mytishchi, 141009

1 Moskvorechye St., Moscow, 115522

https://orcid.org/0000-0001-7215-2212ЗахароваН. И.ZakharovaN. I.

Захарова Нина Ивановна, .м.н., профессор, руководитель отдела неонатальной медицины и когнитивного развития

141009, Московская обл., г. Мытищи, ул. Коминтерна, д. 24а, стр. 1

Nina I. Zakharova, MD, PhD, DSc, Professor, Chief of the Department of Neonatal Medicine and Cognitive Development

Bldg. 1, 24a Kominterna str., Mytishchi, 141009

Балашихинский родильный дом; Научно-исследовательский клинический институт детства Министерства здравоохранения Московской области; Московский областной научно-исследовательский клинический институт имени М.Ф. ВладимирскогоРоссияBalashikha Maternity Hospital; Research Clinical Institute of Childhood of the Moscow Region; Moscow Regional Research Clinical Institute named after M.F. VladimirskyRussian FederationНаучно-исследовательский клинический институт детства Министерства здравоохранения Московской области; Федеральное государственное бюджетное научное учреждение «Медико-генетический научный центр имени академика Н.П. Бочкова»РоссияResearch Clinical Institute of Childhood of the Moscow Region; Federal State Budgetary Scientific Institution Research Centre for Medical GeneticsRussian FederationНаучно-исследовательский клинический институт детства Министерства здравоохранения Московской областиРоссияResearch Clinical Institute of Childhood of the Moscow RegionRussian Federation202619072026427991Copyright © Аксенов Д.В., Кондратьева Е.И., Захарова Н.И., 20262026Аксенов Д.В., Кондратьева Е.И., Захарова Н.И.Aksenov D.V., Kondratyeva E.I., Zakharova N.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nikid.ru/jour/article/view/283

Нарушения гомеостаза глюкозы — гипогликемия и гипергликемия относятся к наиболее частым метаболическим расстройствам неонатального периода и независимо связаны с риском неблагоприятных исходов нейропсихического развития. Распространение непрерывного мониторинга глюкозы (С6М, continuous glucose monitoring) меняет подходы к выявлению дисгликемии, однако его место в неонатологии до конца не определено.

Цель обзора

Цель обзора. Обобщить современные данные о патофизиологии нарушений углеводного обмена у новорожденных, существующих критериях диагностики, методах прерывистого и непрерывного мониторинга глюкозы, а также о влиянии стратегий вскармливания и тактики ведения на ближайшие и отдаленные исходы.

Материалы и методы

Материалы и методы. Выполнен поиск публикаций в базах PubMed/Medline, Scopus, Cochrane Library, eLibrary за 2000-2025 гг. по ключевым словам: neonatal hypoglycemia, neonatal hyperglycemia, continuous glucose monitoring, preterm, feeding, neurodevelopment. В обзор включены клинические рекомендации (AAP, PES, ESPGHAN, проект клинических рекомендаций Российской Федерации 2024 г.), систематические обзоры, метаанализы, рандомизированные и когортные исследования, а также экспертные консенсусы.

Результаты

Результаты. Пороговые значения глюкозы для диагностики гипогликемии варьируют между рекомендательными документами (2,2-2,6 ммоль/л у AAP, = 2,8 ммоль/л у PES в первые 48 часов жизни) и должны выбираться исходя из клинического контекста и возраста ребенка. Непрерывный мониторинг глюкозы в 2-8 раз увеличивает выявляемость гипогликемических эпизодов, преимущественно бессимптомных и ночных, сокращает суммарную продолжительность дисгликемии и при комбинации с алгоритмами поддержки принятия решений снижает вариабельность гликемии у глубоконедоношенных детей. Своевременное прикладывание к груди и контролируемое использование декстрозного геля сопоставимы с инфузией глюкозы по эффективности коррекции бессимптомной гипогликемии, при этом снижают частоту разлучения матери и ребенка. Сохраняются ограничения, связанные с точностью НМГ в зоне низких значений и недостатком данных РКИ о влиянии на отдаленные нейрокогнитивные исходы.

Заключение

Заключение. Внедрение НМГ в практику неонатальных отделений рационально в группах высокого риска при условии валидации устройств, стандартизации алгоритмов реагирования и интеграции данных с клиническим решением. Дальнейшие исследования должны сфокусироваться на определении целевых диапазонов гликемии, оценке отдаленных исходов и экономической эффективности.

Glucose homeostasis disorders – hypoglycemia and hyperglycemia are among the most common metabolic disturbances in the neonatal period and are independently associated with adverse neurodevelopmental outcomes. The growing use of continuous glucose monitoring (CGM) is reshaping dysglycemia detection, yet its place in neonatology remains incompletely defined.

Aim

Aim. To summarise current evidence on the pathophysiology of neonatal glucose disorders, diagnostic thresholds, intermittent and continuous glucose monitoring methods, and the impact of feeding strategies and clinical management on short- and long-term outcomes.

Materials and methods

Materials and methods. PubMed/MEDLINE, Scopus, Cochrane Library and eLIBRARY were searched for publications from 2000 to 2025 using the keywords: neonatal hypoglycemia, neonatal hyperglycemia, continuous glucose monitoring, preterm, feeding, neurodevelopment. Clinical practice guidelines (AAP, PES, ESPGHAN, draft Russian national guidelines 2024), systematic reviews, meta-analyses, randomised and cohort studies and expert consensuses were included.

Results

Results. Glucose thresholds for hypoglycemia vary across guidance documents (2.2–2.6 mmol/L per AAP, ≥ 2.8 mmol/L per PES during the first 48 hours of life) and should be selected according to clinical context and postnatal age. CGM increases the detection of hypoglycemic events 2- to 8-fold – most of them asymptomatic and nocturnal – shortens the cumulative duration of dysglycemia, and when combined with decision-support algorithms reduces glycemic variability in extremely preterm infants. Timely breastfeeding and supervised dextrose gel are comparable to intravenous glucose infusion for managing asymptomatic hypoglycemia, while reducing mother–infant separation. Limitations remain related to CGM accuracy at low glucose concentrations and the paucity of randomised data on long-term neurocognitive outcomes.

Conclusion

Conclusion. Implementation of CGM in neonatal units is justified in high-risk groups, provided that devices are validated, response algorithms are standardised and CGM data are integrated into clinical decision-making. Future research should define target glycemic ranges, evaluate long-term outcomes and assess cost-effectiveness.

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The authors declare that there are no conflicts of interest present.