.png){kind=icon}
.png){kind=icon}
Return
Continuous Glucose Monitoring and Maternal and Neonatal Morbidity in Pregnant People With Type 1 Diabetes
.png){kind=icon}
PRE
AI
DOI：10.1177/19322968251388119.png)
.png){kind=icon}
Original request for help.png){kind=icon}
Share.png){kind=icon}
Save
Abstract
En 中文
<jats:sec>
<jats:title>Introduction:</jats:title>
<jats:p>Prior studies have not identified if continuous glucose monitoring (CGM) metrics at a critical gestational age window can discriminate risk of adverse pregnancy outcomes. We evaluated late second- and third-trimester CGM metrics by gestational age associated with pregnancy outcomes in gravidas with type 1 diabetes (T1DM).</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>
Dexcom G6 CGM data from a retrospective cohort of singleton gestations with T1DM (2018-2022) at an academic medical center were analyzed. Time in, above, and below range 63 to 140 mg/dL (TIR, TAR, TBR), glycemic variability, and mean glucose concentration were computed in two-week CGM intervals from 24
<jats:sup>0</jats:sup>
to 39
<jats:sup>6</jats:sup>
weeks
<jats:sup>days</jats:sup>
. Adverse pregnancy outcomes were hypertensive disorders of pregnancy (HDP), large-for-gestational age (LGA), and neonatal hypoglycemia. Linear mixed-effects models were fitted on CGM metrics computed from two-week CGM intervals, with gestational age, adverse pregnancy outcomes (i.e. presence/absence of HDP, LGA, and/or neonatal hypoglycemia), and their interaction as fixed effects.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>
In 87 gravidas with preconception median hemoglobin A1c 6.5% (IQR 6.0, 7.1) and maternal body mass index 24.8 kg/m
<jats:sup>2</jats:sup>
(IQR 21.9, 27.1), 71% had at least one adverse pregnancy outcome. Between weeks 24
<jats:sup>0</jats:sup>
and 37
<jats:sup>6</jats:sup>
, gravidas with HDP had higher TAR and mean glucose and lower TIR (
<jats:italic toggle="yes">P</jats:italic>
< .05). Gravidas with LGA had lower TBR between weeks 24
<jats:sup>0</jats:sup>
and 35
<jats:sup>6</jats:sup>
. TIR, TAR, and mean glucose evolution differed by HDP status, with greatest divergence between groups at 28
<jats:sup>0</jats:sup>
to 29
<jats:sup>6</jats:sup>
weeks’ gestation (
<jats:italic toggle="yes">P</jats:italic>
≤ .001).
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusion:</jats:title>
<jats:p>CGM metrics in the late second to early third trimester, a period of peak insulin resistance, may help to distinguish risk of HDP and LGA in gravidas with T1DM.</jats:p>
</jats:sec>
Journal
IF:
3.7
Papers:
1.5K
Citations:
6.8K
Organization
View more organizations