Antenatal and Neonatal Endocrinology

Background: Neonatal hypoglycemia can lead to devastating consequences. Thus, constant, accurate and safe glucose monitoring is imperative in neonatal care. However, point-of-care (POC) devices for glucose testing currently used for neonates were originally designed for adults and do not address issues specific to neonates. Methods: This review addresses currently available monitoring options and describes a new methodology for non-invasive blood glucose monitoring in newborns. Results: The authors outline the current blood glucose monitoring options in the newborn period and then describe a potentially novel non-invasive method for measuring blood glucose levels. The method developed depends on using a glucose sensor based on the glucose-binding protein (GBP). The GBP is found in the periplasmic space of Gram-negative bacteria. The GBP is not an enzyme and signal transduction is effected through the change in conformation of the protein upon binding of glucose. The advantage of this change in protein conformation has been taken up by strategically introducing a cysteine mutation at position 255 and labelling that mutation with the polarity-sensitive dye, acrylodan. Changes in the fluorescent properties of the dye are then correlated with the concentration of the analyte (glucose) in the sample. Conclusions: Non-invasive blood glucose monitoring method could potentially change the way we measure bedside blood glucose in the newborn period.