Yogev Yariv, Chen Rony, Ben-Haroush Avi, Phillip Moshe, Jovanovic Lois, Hod Moshe
Department of Obstetrics and Gynecology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
Obstet Gynecol. 2003 Apr;101(4):633-8. doi: 10.1016/s0029-7844(02)02714-x.
To compare the daily glycemic profile reflected by continuous and intermittent blood glucose monitoring in pregnant women with type 1 diabetes and to compare the treatment protocols based on the two monitoring methods.
The study sample consisted of 34 gravid patients at gestational weeks 16-32, with type 1 diabetes being treated by multiple insulin injections. Data derived from the continuous glucose monitoring system for 72 hours were compared with finger stick glucose measurements performed 6-8 times per day. During the study period, patients documented the time of food intake, insulin injections, and hypoglycemic events. Data on demographics, gravidity, parity, body mass index, hemoglobin A1c, and fructosamine levels were collected for each patient.
An average (+/- standard deviation) of 780 +/- 54 glucose measurements was recorded for each patient with continuous glucose monitoring. The mean total time of hyperglycemia (glucose level greater than 140 mg/dL) undetected by the finger stick method was 192 +/- 28 minutes per day. Nocturnal hypoglycemic events (glucose level less than 50 mg/dL) were recorded in 26 patients; in all cases, there was an interval of 1-4 hours before clinical manifestations appeared or the event was revealed by random blood glucose examination. Based on the additional information obtained by continuous monitoring, the insulin therapeutic regimen was adjusted in 24 patients (70%).
Continuous glucose monitoring can diagnose high postprandial blood glucose levels and nocturnal hypoglycemic events that are unrecognized by intermittent blood glucose monitoring and may serve as a basis for determining treatment regimens. A large, prospective study on maternal and neonatal outcome is needed to evaluate the clinical implications of this new monitoring technique.
比较1型糖尿病孕妇连续和间断血糖监测所反映的每日血糖情况，并比较基于这两种监测方法的治疗方案。
研究样本包括34例孕16 - 32周的孕妇，她们均为1型糖尿病患者，采用多次胰岛素注射治疗。将连续血糖监测系统72小时的数据与每天进行6 - 8次的指尖血糖测量数据进行比较。在研究期间，患者记录食物摄入时间、胰岛素注射时间和低血糖事件。收集每位患者的人口统计学、妊娠次数、产次、体重指数、糖化血红蛋白和果糖胺水平等数据。
每位患者通过连续血糖监测平均记录了780±54次血糖测量值。指尖血糖检测未发现的高血糖（血糖水平大于140mg/dL）平均总时间为每天192±28分钟。26例患者记录到夜间低血糖事件（血糖水平小于50mg/dL）；在所有病例中，从低血糖发生到临床表现出现或通过随机血糖检查发现该事件，间隔时间为1 - 4小时。基于连续监测获得的额外信息，24例患者（70%）的胰岛素治疗方案得到了调整。
连续血糖监测能够诊断出间断血糖监测无法识别的餐后高血糖水平和夜间低血糖事件，并可作为确定治疗方案的依据。需要进行一项关于母婴结局的大型前瞻性研究，以评估这种新监测技术的临床意义。
