Manderson John G, Patterson Christopher C, Hadden David R, Traub Anthony I, Ennis Cieran, McCance David R
Royal Jubilee Maternity Hospital, Royal Victoria Hospital Belfast, Northern Ireland.
Am J Obstet Gynecol. 2003 Aug;189(2):507-12. doi: 10.1067/s0002-9378(03)00497-6.
This study was undertaken to compare preprandial and postprandial capillary glucose monitoring in pregnant women with type 1 diabetes.
Sixty-one women with type 1 diabetes were randomly assigned at 16 weeks' gestation to preprandial or postprandial blood glucose monitoring using memory-based glucose reflectance meters throughout pregnancy. Serial measurements of hemoglobin A1c and fructosamine were obtained throughout pregnancy. Insulin, glucose, and insulin-like growth factor-I (IGF-I) were measured in cord blood at delivery. Neonatal anthropometric measures were performed within 72 hours of delivery
Maternal age, parity, age of onset of diabetes, number of prior miscarriages, smoking status, social class, weight gain in pregnancy, and compliance with therapy were similar in the two groups. The postprandial monitoring group had a significantly reduced incidence of preeclampsia (3% vs 21%, P<.048), a greater success in achieving glycemic control targets (55% vs 30%, P<.001) and a smaller neonatal triceps skinfold thickness (4.5+/-0.9 vs 5.1+/-1.3, P=.05).
Postprandial capillary blood glucose monitoring in type 1 diabetic pregnancy may significantly reduce the incidence of preeclampsia and neonatal triceps skinfold thickness compared with preprandial monitoring.
本研究旨在比较1型糖尿病孕妇餐前和餐后毛细血管血糖监测情况。
61例1型糖尿病孕妇在妊娠16周时被随机分配，在整个孕期使用基于记忆的血糖反射仪进行餐前或餐后血糖监测。在整个孕期对糖化血红蛋白和果糖胺进行系列测量。在分娩时测量脐血中的胰岛素、葡萄糖和胰岛素样生长因子-I（IGF-I）。在分娩后72小时内进行新生儿人体测量。
两组孕妇的年龄、产次、糖尿病发病年龄、既往流产次数、吸烟状况、社会阶层、孕期体重增加以及治疗依从性相似。餐后监测组先兆子痫的发生率显著降低（3%对21%，P<0.048），在实现血糖控制目标方面更成功（55%对30%，P<0.001），新生儿肱三头肌皮褶厚度更小（4.5±0.9对5.1±1.3，P = 0.05）。
与餐前监测相比，1型糖尿病孕妇进行餐后毛细血管血糖监测可能会显著降低先兆子痫的发生率和新生儿肱三头肌皮褶厚度。
