This article is more than 5 years old. Information may no longer be current.
CGM reveals trimester-specific differences in pregnant women, links to larger babies
Click Here to Manage Email Alerts
Fluctuating glucose levels in pregnant women with diabetes, revealed through continuous glucose monitoring, may be associated with babies who are large for gestational age, according to research in Diabetes Care.
The study is the first to investigate glucose levels measured with continuous glucose monitoring (CGM) in relation to birth weight, according to researchers. In each trimester of pregnancy, mothers who delivered babies large for gestational age showed significantly different glucose levels than those who delivered babies born within a healthy weight range. In particular, women who delivered babies large for gestational age exhibited lower and less variable glucose levels in the first trimester and higher, more variable glucose levels in the second and third trimester, according to researchers.
“Functional data analysis of CGM data identified specific times of day that maternal glucose excursions were associated with large for gestational age infants,” Eleanor M. Scott, MD, FRCP, a senior researcher at the Leeds Institute of Cardiovascular and Metabolic Medicine at University of Leeds, United Kingdom, told Endocrine Today. “It highlights trimester-specific differences allowing treatment to be targeted to gestational glucose patterns.”
Scott and colleagues at other institutions analyzed data from 117 pregnant women with type 1 (n = 89) and type 2 (n = 28) diabetes, who used CGM during their pregnancies. Researchers applied functional data analysis to 1.68 million glucose measurements from 759 measurement episodes.
During the study, 54 women (46%) delivered babies large for gestational age. These births were associated with a lower mean glucose in the first trimester (7 mmol/L vs. 7.1 mmol/L; P < .01) and with a higher mean glucose level in both the second (7 mmol/L vs. 6.7 mmol/L; P < .001) and third trimesters (6.5 mmol/L vs. 6.4 mmol/L; P < .01).
Among women with infants who were large for gestational age, functional data analysis showed that glucose levels varied by both time of day and by trimester. In the first trimester, glucose was significantly lower during mid-morning (9 a.m. to 11 a.m.) and early evening (7 p.m. to 9:30 p.m.), whereas in the second trimester, levels were significantly higher in the early morning (3:30 a.m. to 6:30 a.m.) and throughout the afternoon (11:30 a.m. to 5 p.m.) and significantly higher during the evening (8:30 p.m. to 11:30 p.m.) during the third trimester, according to researchers.
“Analyzing CGM by functional data analysis allows us to understand where, when and how we might better invest efforts to optimize glucose control and, thus, improve pregnancy outcomes,” Scott said.
“The next stage of the research would be to use its findings to help with the design of closed-loop insulin algorithms, which are being developed to transform the care of people with type 1 diabetes who are reliant on insulin,” Scott said. – by Regina Schaffer
For more information:
Eleanor M. Scott, MD, FRCP can be reached at the Leeds Institute of Cardiovascular and Metabolic Medicine, Clarendon Way, University of Leeds, Leeds LS2 9JT, UK; email: e.m.scott@leeds.ac.uk
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts