Yale School of Public Health, Department of Chronic Disease Epidemiology, New Haven, CT, USA.
Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):8968-8974. doi: 10.1080/14767058.2021.2008895. Epub 2021 Dec 7.
Pregnancies complicated by type 1 diabetes (T1D) experience high levels of glycemic variability, which may be associated with adverse maternal and neonatal outcomes. Therefore, strategies that help pregnant women with T1D manage their glycemic control are of great interest.
We examined associations with or without remote monitoring of Continuous Glucose Monitor (CGM) data by friends and family with indices of glycemic control and glycemic variability during pregnancies complicated by T1D in a pilot non-randomized trial ( = 28). During preconception or the first trimester, participants were placed in one of two groups based on device compatibility: (1) CGM Alone ( = 13): women without iPhone, iPad or iPod Touch; or (2) CGM Share ( = 15): women with iPhone, iPad, or iPod Touch and followers with devices compatible for data viewing. Linear mixed models were used to compare indices of glycemic control and glycemic variability over time between groups.
Participants using CGM Share had lower estimated HbA1c levels over time ( = .028), glucose management index ( = .041), and fewer glucose excursions >200 mg/dL in each trimester ( = .022) compared to those using CGM Alone. Participants using CGM Alone had higher high blood glucose index ( = .020), mean area under the curve ( = .026), and standard deviation ( = .046) compared to those using CGM Share. Other measures of glycemic variability did not differ between groups.
In this non-randomized pilot study, use of CGM Share was associated with improvements in several indices of glycemic control and glycemic variability.
患有 1 型糖尿病（T1D）的妊娠会经历高水平的血糖变异性，这可能与不良的母婴和新生儿结局有关。因此，帮助 T1D 孕妇管理血糖控制的策略非常重要。
我们在一项非随机试验（n=28）中检查了 T1D 妊娠期间通过朋友和家人远程监测连续血糖监测（CGM）数据与血糖控制和血糖变异性相关的指标，参与者根据设备兼容性分为两组：（1）CGM 单独组（n=13）：无 iPhone、iPad 或 iPod Touch 的女性；或（2）CGM 共享组（n=15）：有 iPhone、iPad 或 iPod Touch 且有设备兼容数据查看的女性。线性混合模型用于比较两组之间随时间变化的血糖控制和血糖变异性指标。
与 CGM 单独组相比，使用 CGM 共享组的参与者的 HbA1c 水平（n=0.028）、血糖管理指数（n=0.041）和每个孕期血糖>200mg/dL 的葡萄糖 excursions 次数（n=0.022）均较低。与 CGM 共享组相比，使用 CGM 单独组的参与者的高血糖指数（n=0.020）、平均曲线下面积（n=0.026）和标准差（n=0.046）较高。血糖变异性的其他指标在两组之间没有差异。
在这项非随机的初步研究中，使用 CGM 共享与血糖控制和血糖变异性的几个指标的改善相关。
