配对连续血糖监测在伴有 1 型糖尿病妊娠中的可行性研究：产时和新生儿期。
A Feasibility Study of Paired Continuous Glucose Monitoring Intrapartum and in the Newborn in Pregnancies Complicated by Type 1 Diabetes.
机构信息
1 Department of Clinical Biochemistry, Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom.
2 Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom.
出版信息
Diabetes Technol Ther. 2019 Jan;21(1):20-27. doi: 10.1089/dia.2018.0221.
AIM
To describe the continuous glucose monitoring (CGM) profiles of type 1 diabetes (T1D) offspring in the early neonatal period and its association with maternal intrapartum glucose control.
METHODS
A prospective observational study of T1D pregnant women and their neonatal offspring. Women had a CGM sensor inserted 2-3 days before delivery. Infants had a masked CGM sensor inserted as soon as possible after delivery. Maternal glycemic outcomes were time-in-target (70-140 mg/dL [3.9-7.8 mmol/L]), hyperglycemia >140 mg/dL (7.8 mmol/L), and mean CGM glucose during the 24 h preceding delivery. Neonatal outcomes included lowest recorded blood glucose concentration, and CGM measures (glucose <47 mg/dL [2.6 mmol/L], time-in-target (47-144 mg/dL [2.6-8.0 mmol/L]), glucose standard deviation [SD]) during the first 72 h of life.
RESULTS
Data were available for 16 mother-infant pairs. Mothers had a mean age (SD) 32.3 (4.3) years, T1D duration 17.6 (6.8) years, first antenatal glycated hemoglobin 7.4 (0.8)% (57 [8.5] mmol/mol). In the 24 h preceding delivery, mothers spent mean (SD) 72 (20)% time-in-target (70-140 mg/dL [3.9-7.8 mmol/L]), 19 (15)% time >140 mg/dL (7.8 mmol/L), and 9 (9)% time <70 mg/dL (3.9 mmol/L) with mean (SD) CGM glucose 113 (9) mg/dL (6.3 [0.7] mmol/L). Fifteen infants (93.8%) had ≥1 blood glucose concentration <47 mg/dL (2.6 mmol/L), and five had ≥1 blood glucose concentration <18 mg/dL (1.0 mmol/L). The mean infant CGM glucose on days 1, 2, and 3 of life was 63 (14), 67 (13), 76 (11) mg/dL (3.5 [0.8], 3.7 [0.7], and 4.2 [0.6] mmol/L). Four infants (25%) spent >50% time with CGM glucose levels <47 mg/dL (2.6 mmol/L) on day 1.
CONCLUSIONS
CGM detected widespread neonatal hypoglycemia, even among mothers with good intrapartum glucose control.
目的
描述 1 型糖尿病（T1D）患儿新生儿早期的连续血糖监测（CGM）曲线，并探讨其与产妇产时血糖控制的关系。
方法
这是一项前瞻性观察性研究，纳入了 T1D 孕妇及其新生儿。孕妇在分娩前 2-3 天插入 CGM 传感器，新生儿在分娩后尽快插入 CGM 传感器。产妇的血糖控制结局包括目标范围内时间（70-140mg/dL[3.9-7.8mmol/L]）、高血糖（>140mg/dL[7.8mmol/L]）和分娩前 24 小时内的平均 CGM 血糖。新生儿结局包括最低记录血糖浓度和 CGM 指标（血糖<47mg/dL[2.6mmol/L]、目标范围内时间（47-144mg/dL[2.6-8.0mmol/L]）、血糖标准差[SD]）。
结果
本研究共纳入 16 对母婴。母亲的平均（标准差）年龄为 32.3（4.3）岁，T1D 病程为 17.6（6.8）年，首诊时糖化血红蛋白为 7.4（0.8）%（57[8.5]mmol/mol）。分娩前 24 小时，母亲的目标范围内时间（70-140mg/dL[3.9-7.8mmol/L]）、高血糖时间（>140mg/dL[7.8mmol/L]）和低血糖时间（<70mg/dL[3.9mmol/L]）分别占总时间的 72（20）%、19（15）%和 9（9）%，平均 CGM 血糖为 113（9）mg/dL（6.3[0.7]mmol/L）。15 名婴儿（93.8%）至少有 1 次血糖浓度<47mg/dL（2.6mmol/L），5 名婴儿至少有 1 次血糖浓度<18mg/dL（1.0mmol/L）。婴儿出生后第 1、2、3 天的平均 CGM 血糖分别为 63（14）mg/dL（3.5[0.8]mmol/L）、67（13）mg/dL（3.7[0.7]mmol/L）和 76（11）mg/dL（4.2[0.6]mmol/L）。有 4 名婴儿（25%）在第 1 天有>50%的 CGM 血糖水平<47mg/dL（2.6mmol/L）。
结论
CGM 检测到新生儿严重低血糖，即使产妇产时血糖控制良好也会发生。
Zotero 插件