Collaborative study looks at development of infants at risk of hypoglycaemia

Researchers from the University of Canterburys Bioengineering Mechatronics Programme are part of a large, collaborative project looking at the development of young children who were at risk of hypoglycaemia, or low blood sugar, in their early neonatal period.

Director of the UC Mechatronics Programme, Professor Geoff Chase, says UC researchers are involved in the project because of their expertise with hyperglycaemia through the management of patients with high blood sugar at both the adult ICU at Christchurch Hospital and in extremely pre-term infants at Christchurch Womens NICU, as well as expertise in managing complex data and signals.

We model the major human physiological systems the metabolic system, the cardio-vascular system and pulmonary mechanics. We then use these models, with data in clinic, to provide better monitoring of something that cannot be measured directly with ease, or in diagnostics, or to guide treatment, he says.

The multi-disciplinary study, called CHYLD (Children with Hypoglycaemia and their Later Development), is based at The University of Auckland, led by Distinguished Professor Jane Harding from the Liggins Institute.

It was Professor Chases team that, several years ago, developed the Specialised Relative Insulin Nutrition Table (SPRINT), a laminated wheel-based system to control blood glucose levels and nutritional intakes in intensive care patients. Already proven to have saved 50 lives a year and $1m/year in costs at Christchurch Hospital, the system has now been improved and computerised.

We are very familiar with the continuous glucose monitors (CGMs) that are used in this study, says Professor Chase. These are tiny sensors which, when inserted under the skin, can sense subcutaneous glucose. To remove the need for invasive testing which was previously done by pinstick, CGMs were used to measure blood sugar concentrations of the newborn babies in the study at Waikato Hospital.

CGMs do need frequent calibration however, and can produce significant random noise. The way you calibrate the devices can change the data produced, and thus the results, so how this is done and the way that subsequent data is managed is something that best leverages engineering skills.

Hypoglycaemia in neonatal infants can cause brain damage, but currently it is not known which babies will be affected or what levels of blood sugar might trigger the damage.

The CHYLD study investigates the development of children from two neonatal studies. The first, BABIES, observed 100 newborns from the NICU at Waikato Hospital between December 2006 and February 2009. The second, Sugar Babies, recruited 514 babies between November 2008 and November 2010.

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Development of infants at risk of hypoglycaemia - study