Diabetes Care Unit, Department of Endocrinology and Diabetes, Catholic University of Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Department of Clinical Biochemistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
J Diabetes Res. 2021 Aug 23;2021:9987646. doi: 10.1155/2021/9987646. eCollection 2021.
Continuous glucose monitoring (CGM) might be an effective tool to improve glycemic control in gestational diabetes mellitus (GDM). Few data are available about its utilization as a diagnostic tool to find potential alterations of glycemia in subjects with normal oral glucose tolerance test (OGTT). In this preliminary prospective real-life observational study, we aimed to analyze the glycemic pattern in normal and gestational diabetes mellitus (GDM) women by continuous glucose monitoring (CGM) in order to detect potential differences between the two groups and glycemic alterations despite a normal OGTT. After the screening for GDM, subjects were connected to a CGM system for seven consecutive days. The areas under the curve of the first 60 minutes after each meal and 60 minutes before breakfast were analyzed. Women with normal OGTT that during CGM showed impaired glycemic values (more than 95 fasting or more than 140 one hour after meals or more than 120 two hours after meals) performed one week of self-monitoring of blood glucose (SMBG). After OGTT, 53 women considered normal and 46 affected by GDM were included. CGM parameters did not show any differences between the two groups with impaired glycemic excursions found in both groups. After CGM period, 33 women with normal OGTT showed abnormal glycemic patterns. These 33 women then performed one week of SMBG. After evaluation of one week of SMBG, 21 required diet therapy and 12 required insulin treatment and were followed until the delivery. An increase in gestational weight gain was observed in normal women with normal OGTT but this was not significant. No significant data were found regarding neonatal outcomes in the two groups of women. In conclusion, CGM use in pregnancy might help to detect glycemic fluctuations in women with normal OGTT, improving their treatment and outcomes.
连续血糖监测（CGM）可能是改善妊娠期糖尿病（GDM）患者血糖控制的有效工具。关于其作为诊断工具在口服葡萄糖耐量试验（OGTT）正常的受试者中发现潜在血糖变化的应用数据很少。在这项初步前瞻性真实观察研究中，我们旨在通过连续血糖监测（CGM）分析正常和妊娠期糖尿病（GDM）女性的血糖模式，以检测两组之间的潜在差异以及尽管 OGTT 正常但血糖仍发生改变的情况。在筛查 GDM 后，受试者连续 7 天连接到 CGM 系统。分析每餐 60 分钟后和早餐前 60 分钟的曲线下面积。OGTT 期间出现血糖值受损（餐后 95 分钟以上或餐后 140 分钟以上或餐后 120 分钟以上）的 OGTT 正常女性进行一周的自我血糖监测（SMBG）。OGTT 后，纳入 53 名正常 OGTT 的女性和 46 名 GDM 患者。两组之间的 CGM 参数没有显示出任何差异，两组都存在血糖波动异常。CGM 期后，33 名 OGTT 正常的女性出现异常血糖模式。这 33 名女性随后进行了一周的 SMBG。评估一周的 SMBG 后，21 名需要饮食治疗，12 名需要胰岛素治疗，并一直随访至分娩。正常 OGTT 的正常女性体重增加，但无显著差异。两组女性的新生儿结局均无显著数据。总之，CGM 在妊娠中的应用可能有助于检测 OGTT 正常女性的血糖波动，改善其治疗和结局。
