Department of Medicine, Unit of Metabolic Diseases, University of Padua, Via Giustiniani no. 2, 35128 Padua, Italy.
Int J Endocrinol. 2013;2013:279021. doi: 10.1155/2013/279021. Epub 2013 Nov 11.
Continuous glucose monitoring (CGM) gives a unique insight into magnitude and duration of daily glucose fluctuations. Limited data are available on glucose variability (GV) in pregnancy. We aimed to assess GV in healthy pregnant women and cases of type 1 diabetes mellitus or gestational diabetes (GDM) and its possible association with HbA1c. CGM was performed in 50 pregnant women (20 type 1, 20 GDM, and 10 healthy controls) in all three trimesters of pregnancy. We calculated mean amplitude of glycemic excursions (MAGE), standard deviation (SD), interquartile range (IQR), and continuous overlapping net glycemic action (CONGA), as parameters of GV. The high blood glycemic index (HBGI) and low blood glycemic index (LBGI) were also measured as indicators of hyperhypoglycemic risk. Women with type 1 diabetes showed higher GV, with a 2-fold higher risk of hyperglycemic spikes during the day, than healthy pregnant women or GDM ones. GDM women had only slightly higher GV parameters than healthy controls. HbA1c did not correlate with GV indicators in type 1 diabetes or GDM pregnancies. We provided new evidence of the importance of certain GV indicators in pregnant women with GDM or type 1 diabetes and recommended the use of CGM specifically in these populations.
连续血糖监测 (CGM) 可以深入了解日常血糖波动的幅度和持续时间。关于妊娠期间血糖变异性 (GV) 的数据有限。我们旨在评估健康孕妇、1 型糖尿病或妊娠期糖尿病 (GDM) 患者的 GV 及其与 HbA1c 的可能关联。在妊娠的所有三个阶段对 50 名孕妇（20 名 1 型糖尿病、20 名 GDM 和 10 名健康对照组）进行了 CGM 检查。我们计算了平均血糖波动幅度 (MAGE)、标准差 (SD)、四分位间距 (IQR) 和连续重叠净血糖作用 (CONGA)，作为 GV 参数。还测量了高血糖指数 (HBGI) 和低血糖指数 (LBGI)，作为高血糖和低血糖风险的指标。1 型糖尿病患者的 GV 较高，白天发生高血糖峰值的风险是健康孕妇或 GDM 患者的 2 倍。GDM 患者的 GV 参数仅略高于健康对照组。1 型糖尿病或 GDM 妊娠患者的 HbA1c 与 GV 指标不相关。我们提供了新的证据，证明在 GDM 或 1 型糖尿病孕妇中某些 GV 指标的重要性，并建议在这些人群中特别使用 CGM。
