Novel Continuous Glucose Monitoring Metrics and Large-for-Gestational-Age Risk: An Exploratory Retrospective Cohort Study in Pregnancies with Type 1 Diabetes
| Autor: | Urszula Mantaj, Beata Mrzewka-Rogacz, Rafał Sibiak, Ewa Wender-Ozegowska, Paweł Gutaj |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Blood Glucose
medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment Cohort Studies Endocrinology Pregnancy Diabetes mellitus medicine Humans Retrospective Studies Glycemic Glycated Hemoglobin Type 1 diabetes Obstetrics business.industry Blood Glucose Self-Monitoring Insulin Incidence (epidemiology) Infant Newborn nutritional and metabolic diseases Retrospective cohort study medicine.disease Benchmarking Medical Laboratory Technology Diabetes Mellitus Type 1 Glucose Cohort Female business |
| Zdroj: | Diabetes Technology & Therapeutics. 24:42-53 |
| ISSN: | 1557-8593 1520-9156 |
| DOI: | 10.1089/dia.2021.0194 |
| Popis: | Background Continuous glucose monitoring (CGM) improves pregnancy outcomes in patients with type 1 diabetes (T1D). We aimed to assess the between-group differences in HbA1c and the incidence of large-for-gestational-age (LGA) neonates in CGM and glucometers users and analyze the potential association of novel CGM metrics with LGA risk in T1D pregnancies. Material and methods The initial study cohort included 134 women with T1D treated with insulin pumps -75 CGM users and 59 patients who measured their glucose concentrations using glucometers. As part of our study, we matched the CGM users and patients who preferred the self-monitoring of blood glucose (SMBG) according to their baseline HbA1c and White's diabetes class at a 1:1 ratio. After the matching, both groups included 42 pregnancies. Results We did not find any differences in changes in HbA1c and perinatal outcomes between CGM and SMBG users; however, we achieved a limited statistical power, and there were more cases of diabetic nephropathy in the SMBG group. Mothers of LGA infants had higher 1st-trimester HbA1c, time above target, and mean glucose concentrations in each trimester of pregnancy. Other CGM metrics reflecting glucose fluctuations attributed to hyperglycemia were associated with an increased risk of LGA. Despite optimal maternal HbA1c, 39% of neonates demonstrated LGA. Conclusions Although most of the patients reached the target HbA1c concentrations, mothers of LGA newborns had higher 1st-trimester HbA1c, time above target, and mean glucose concentrations in each trimester of pregnancy. However, our preliminary data show that glycemic fluctuations metrics may serve as additional parameters predicting LGA in pregnancies with T1D. |
| Databáze: | OpenAIRE |
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