Mazze Roger, Yogev Yariv, Langer Oded
WHO Collaborating Center, International Diabetes Center and Mayo Clinic, Minneapolis, MN 55416, USA.
J Matern Fetal Neonatal Med. 2012 Jul;25(7):1171-5. doi: 10.3109/14767058.2012.670413. Epub 2012 May 17.
In pregnancy complicated by diabetes periods of hyperglycemia lead to accelerated fetal growth, resulting in a large for gestational age (LGA), or macrosomic, infant. Consequently, our aim was to measure the average volatility or variability in glucose control in women with and without diabetes in pregnancy.
Continuous glucose monitoring (CGM) was employed in 82 pregnant study subjects to collect and record unbiased self-monitored glucose values. We obtained results from 51 women with normal glucose tolerance in pregnancy (NGTP), 25 gestational diabetes (GDM) and 6 women with pregestational diabetes (PreGD) between 18 and 45 (32 ± 6) years of age.
Significant differences (p < 0.001) were found in glucose exposure between NGT and all but PreGD; whereas the percent of time in hypoglycemia was significantly (p < 0.0001) higher in all pregnancy groups when compared to the nonpregnant sample. We conclude that CGM confirmed that diurnal glucose patterns differ throughout the day by 20% when pregnant and nonpregnant states are compared. Indeed, maintenance of a narrow range in pregnancy is characteristic in women without diabetes, and CGM throughout pregnancy is critical, if mimicking normal glucose patterns is to be achieved.
在糖尿病合并妊娠中，高血糖期会导致胎儿生长加速，从而产生大于胎龄（LGA）或巨大儿。因此，我们的目的是测量妊娠期间患有和未患有糖尿病的女性血糖控制的平均波动或变异性。
对82名怀孕研究对象采用持续葡萄糖监测（CGM）来收集和记录无偏差的自我监测血糖值。我们获得了51名妊娠期间糖耐量正常（NGTP）的女性、25名妊娠期糖尿病（GDM）女性和6名孕前糖尿病（PreGD）女性的结果，她们年龄在18至45岁（32±6岁）之间。
在NGT与除PreGD外的所有组之间，血糖暴露存在显著差异（p<0.001）；而与未怀孕样本相比，所有妊娠组低血糖时间百分比显著更高（p<0.0001）。我们得出结论，CGM证实，比较怀孕和未怀孕状态时，全天的昼夜血糖模式差异达20%。确实，在无糖尿病的女性中，妊娠期间维持较窄的血糖范围是其特征，并且如果要模拟正常血糖模式，整个孕期进行CGM至关重要。
