McLachlan Kylie, Jenkins Alicia, O'Neal David
Department of Medicine, St Vincent's Hospital, University of Melbourne, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2007 Jun;47(3):186-90. doi: 10.1111/j.1479-828X.2007.00716.x.
The continuous glucose monitoring system (CGMS) is a novel tool to assess 24-h glucose fluctuations. In pregnancies complicated by diabetes, where excellent glucose control is desired to improve maternal and fetal outcomes, CGMS may have a role in fine-tuning management.
To assess the usefulness of CGMS in pregnant women with diabetes for medical decision-making and to evaluate patient tolerability and perception of usefulness.
Pregnant women with diabetes at the Werribee Mercy Hospital were offered CGMS in the setting of their standard diabetes care. Treating clinicians were asked if the CGMS altered management decisions from those based on conventional glucose monitoring. The accuracy of the CGMS was assessed by comparison with the patients' finger-prick glucose readings. Patients completed a feedback questionnaire after having the CGMS and viewing their results.
CGMS traces (n = 68) were obtained in 55 pregnant women - 37 with gestational diabetes, ten with type 2 and eight with type 1 diabetes. Forty-two of 68 (62%) traces were assessed as providing additional information which altered clinical management decisions. This included showing undetected postprandial hyperglycaemia and overnight hypoglycaemia. Subject feedback was generally positive, with 37 of 48 (77%) respondents reporting that the benefits of the CGMS outweighed the inconvenience.
CGMS is a well-tolerated clinically useful tool in the management of gestational diabetes and pre-existing diabetes in pregnancy.
连续血糖监测系统（CGMS）是评估24小时血糖波动的一种新型工具。在合并糖尿病的妊娠中，为改善母婴结局需要良好的血糖控制，CGMS可能在优化管理中发挥作用。
评估CGMS在糖尿病孕妇医疗决策中的有用性，并评估患者的耐受性和对有用性的认知。
在Werribee Mercy医院，为患有糖尿病的孕妇在其标准糖尿病护理过程中提供CGMS。询问治疗医生CGMS是否改变了基于传统血糖监测的管理决策。通过与患者指尖血糖读数比较来评估CGMS的准确性。患者在使用CGMS并查看结果后完成一份反馈问卷。
55名孕妇获得了CGMS记录（n = 68）——37名患有妊娠期糖尿病，10名患有2型糖尿病，8名患有1型糖尿病。68份记录中有42份（62%）被评估为提供了改变临床管理决策的额外信息。这包括显示未被检测到的餐后高血糖和夜间低血糖。患者反馈总体上是积极的，48名受访者中有37名（77%）报告称CGMS的益处超过了不便之处。
CGMS是一种耐受性良好的临床有用工具，可用于妊娠期糖尿病和孕前糖尿病的管理。
