Tables at a glance

Table 1

Table 2

Figures at a glance

Figure 1

Figure 2

Figure 3

Figure 4

Table 1

Basic Metabolic Panel
Sodium	136 MMOL/L
Potassium	4.2 MMOL/L
Chloride	98 MMOL/L
CO2	21 MMOL/L
Urea Nitrogen	8 MG/DL
Creatinine	< 0.38 MG/DL
Glucose	129 MG/DL
Calcium	10.5 MG/DL
Anion Gap	17 MMOL/L

Table 1: Basic Metabolic Panel on admission

Table 2

Hospital Day	Time	Dextrose 10% Infusion Rate (ml/hr)	CGM Glucose Reading (mg/dL)	Point-of-Care Glucose (mg/dL)	Feeding Amount (mL)
1	12:00	-	94	113	80
	13:10	-	70 (ALARM)	69	80
	15:30	42	92		120
	19:00	42	98		120
	20:16	42	124		120
2	00:02	42	81		150
	06:45	84	110	109
	08:20	84	111	123
	10:15	84	110
Surgery
	16:30	74	163		120
	19:00	54	136	147
	20:20	54	98
3	00:03	29	114		120 (G-tube)
	03:00	14	95		120
	06:00	-	70 (ALARM)		120

Table 2: Table showing the inpatient feeding and glucose log for each hospital day. Dextrose infusion rate along with feeding volumes included. CGM measurements were similar in value to point-of-care glucose measurements

FIGURE 1

Figure 1: CGM display of glucose values (mg/dL) for typical glycemic trends when the child is well and tolerating feeds every 2 hours at home. Time progression is from the left to the right of the image. Glucose values fall rapidly within 2 hours requiring frequent monitoring of CGM device to coordinate feeds

FIGURE 2

Figure 2: Intraoperative CGM recordings obtained by anesthesia during the procedure

FIGURE 3

Figure 3: CGM display of glucose values (mg/dL) while the child was undergoing continuous dextrose infusion during fasting state (time is measured from the left of the screen to the right). Star indicates drop in glucose while undergoing surgical procedure from 13.1 mg/kg/min to 10.9 mg/kg/min. The up-arrow indicates the first wean of the dextrose infusion following the first enteral feeding post-procedure

FIGURE 4

Figure 4: Continuous glucose monitor shown in the child while standing. Placement of the CGM in the upper outer posterior thigh as seen in the figure. There is a skin mark just lateral to the CGM where an older sensor had been placed. The family switches legs after placing a new sensor and rotate insertion sites