# Continuous glucose monitoring in paediatric residents with normal glucose metabolism: correlations to 24-hour duty schedule

## TL;DR

This study shows that 24-hour shifts in the Emergency Department cause higher and more variable blood glucose levels in healthy pediatric residents.

## Contribution

The study is the first to use continuous glucose monitoring to show how 24-hour ED shifts affect glucose levels in healthy residents.

## Key findings

- Glucose levels were higher during 24-hour ED shifts compared to other days.
- Glucose variability increased during ED duty shifts.
- Nighttime glucose levels were elevated during ED shifts compared to regular nights.

## Abstract

Glucose values in healthy humans are influenced by dietary habits, stress, hormonal signaling and lack of adequate sleep. Our aim was to quantify glucose fluctuations in healthy paediatric residents with the use of commercial continuous glucose monitoring systems(CGMS).

Eligibility criteria were: i)participation in the full on-call duty schedule, ii)age: 25–40 years, iii)normal body mass index (BMI) iv)absence of chronic disease or treatment affecting glucose metabolism and v)signed informed consent.

Fifteen sensors were placed in 13 residents (8 females). They were monitored for 35 days of 24-hour duty shift in the Emergency Department (ED), 35 days after a 24-hour ED shift and 114 days away from 24-hour ED shift (regular 8-hour shift days). Time in normoglycemia (70–140 mg/dl) was lower and time in higher glucose ranges (141–180 mg/dl and 181–250 mg/dl) was higher during ED duty shifts. Most participants showed a significant increase in mean glucose during 24-hour ED duty shifts (97.67 ± 10.84 mg/dl) compared to days after ED duty (94.68 ± 10.16 mg/dl, p = 0.002) and regular working days (97.85 ± 10.08 mg/dl, p < 0.001). Glucose variability, assessed by coefficient of variation, was also higher during ED duty days (15.78) than on days after ED duty (13.85) and regular days (12.91). Night-time glucose (00.00–06.00) was similarly elevated during ED duty shifts (98.85 ± 11.85 mg/dl) compared to nights after ED duty (90.59 ± 10.99 mg/dl, p = 0.002) and nights on regular working days (90.72 ± 10.06 mg/dl, p = 0.003).

24-hour ED duty shifts significantly affect glucose values of Paediatric residents. Further studies are warranted to confirm and further investigate these preliminary data.