Flash glucose monitoring in gestational diabetes mellitus: possibilities for assessing glycemic variability-Reference-Cited by-同舟云学术

Flash glucose monitoring in gestational diabetes mellitus: possibilities for assessing glycemic variability

Published:2021-09-19 Issue:12 Volume: Page:414-419
ISSN:2658-5790
Container-title:Meditsinskiy sovet = Medical Council
language:
Short-container-title:Medicinskij sovet

Author:

Ushanova F. O.¹^ORCID,Demidova T. Yu.¹^ORCID,Izmaylova M. Ya.¹^ORCID

Affiliation:

1. Pirogov Russian National Research Medical University

Abstract

Introduction. Blood glucose monitoring is critical in maintaining glycemic control in women with GDM and in reducing adverse maternal and fetal outcomes. One of the tools that can help achieve optimal glycemic control during pregnancy is continuous glucose monitoring, which empowers clinicians to assess the characteristics of daily glycemic variability.The aim. Compare biweekly glycemic profiles and glycemic variability in pregnant women with GDM and in healthy pregnant women using the FreeStyle Libre flash glycemic monitoring system.Materials and methods. Analysis of the glycemic profile of 49 pregnant women aged 33.2 ± 6.1 years. The average gestational age of the women included in the study was 12.6 ± 6.4 weeks. Pregnant women were divided into 2 groups: 37 pregnant women with GDM and 12 healthy pregnant women. Each group underwent two-week glucose profile monitoring using the FreeStyle Libre continuous monitoring system. Statistical analysis was carried out using Microsoft Office Excel 2016, STATISTICA 10 programs (developed by StatSoft.Inc), EasyGV, version 9.Results. The average glycemic level in the groups was 4.724 ± 0.37 mmol/L vs 4.24 ± 0.34 mmol/L, respectively (p˂0.001). Comparative analysis of GV parameters in groups of pregnant women with and without GDM: SD – 0.908 vs 0.7213 (p˂0.05); LI – 1.5 vs 0.8 (p˂0.05); HBGI – 0.503 vs 0.42 (p˂0.05); J-index – 10.343 vs 7.9870 (p˂0.001); MOOD – 0.956 vs 0.7992 (p˂0.05); MAGE – 2.326 vs 1.8042 (p˂0.05); ADDR – 2.216 vs 0.4210 (p˂0.05); MAG – 4.612 vs 2.6163 (p˂0.001), respectively. The CONGA index did not show a statistically significant difference in both groups: 3.95 vs 3.7 (p = 0.5).Conclusions. Flash-glycemic monitoring can be used to obtain more detailed information about the glycemic profile, especially when it is difficult to assess the degree of GDM compensation. Continuous glucose monitoring can facilitate the optimization of glycemic control and provide a basis for treatment decisions.

Publisher

Remedium, Ltd.

Subject

General Medicine

Reference21 articles.

1. Sacks D.A., Hadden D.R., Maresh M., Deerochanawong C., Dyer A.R., Metzger B.E. et al. Frequency of gestational diabetes mellitus at collaborating centers based on IADPSG consensus panel-recommended criteria: the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. Diabetes Care. 2012;35(3):526–528. https://doi.org/10.2337/dc11-1641.

2. Hedderson M.M., Ferrara A., Sacks D.A. Gestational diabetes mellitus and lesser degrees of pregnancy hyperglycemia: association with increased risk of spontaneous preterm birth. Obstet Gynecol. 2003;102(4):850–856. https://doi.org/10.1016/s0029-7844(03)00661-6.

3. Rayanagoudar G., Hashi A.A., Zamora J., Khan K.S., Hitman G.A., Thangaratinam S. Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta-analysis of 95,750 women. Diabetologia. 2016;59(7):1403–1411. https://doi.org/10.1007/s00125-016-3927-2.

4. Lowe W.L.Jr., Scholtens D.M., Kuang A., Linder B., Lawrence J.M., Lebenthal Y. et. al. HAPO Follow-up Study Cooperative Research Group. Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Gestational Diabetes Mellitus and Childhood Glucose Metabolism. Diabetes Care. 2019;42(3):372–380. https://doi.org/10.2337/dc18-1646.

5. Wei Q., Sun Z., Yang Y., Yu H., Ding H., Wang S. Effect of a CGMS and SMBG on Maternal and Neonatal Outcomes in Gestational Diabetes Mellitus: a Randomized Controlled Trial. Sci Rep. 2016;27(6):19920. https://doi.org/10.1038/srep19920.