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一项对CONCEPTT研究结果的综述,包括对使用持续血糖监测的1型糖尿病孕妇及其后代的亚分析。

A review of CONCEPTT study findings including subanalyses in pregnant women using continuous glucose monitoring with type 1 diabetes and their offspring.

作者信息

Pham David Q, Thorsell Ashley, Castorino Kristin, Cobb Brandon

机构信息

Western University of Health Sciences, College of Pharmacy, Pomona, California, USA.

Mary & Dick Allen Diabetes Center at Hoag Hospital, Newport Beach, California, USA.

出版信息

Endocr Connect. 2024 Jan 11;13(2). doi: 10.1530/EC-23-0407. Print 2024 Feb 1.

Abstract

The main objective of this article is to provide a comprehensive review of continuous glucose monitor (CGM) use in pregnant women with type 1 diabetes (T1D) from the CONCEPTT study including subanalyses. Literature search was accessed through MEDLINE (1966-September 2023) using the key terms: CONCEPTT, pregnancy, women, T1D, and CGM with limitations set to distinguish human subjects written in English. A total of 17 publications including one main clinical trial and 15 subanalyses have been published to date regarding the use of CGM in pregnant women with T1D which were conducted by a research group identified as the CONCEPTT Collaborative Group. While advances in maternal care have resulted in safer pregnancy for both the mother and child, women with preexisting T1D and pregnancy still experience higher rates of complications both in the short and long term. The use of CGM in pregnancy has not been studied extensively until more recently. The CONCEPTT clinical trial was a landmark study that involved several subanalyses. The main trial proved that CGM use in T1D pregnancy resulted in less hyperglycemia in the third trimester, reduced large for gestational age (LGA, >90th percentile), reduced neonatal intensive care unit admissions lasting longer than 24 h, and reduced neonatal hypoglycemia. Although subanalyses showed a variety of results including 'inconclusive' due to lack of prespecification, it is believed that CGM in T1D during pregnancy is to be recommended and used for overall improved outcomes.

摘要

本文的主要目的是对来自CONCEPTT研究(包括亚分析)的1型糖尿病(T1D)孕妇使用持续葡萄糖监测(CGM)进行全面综述。通过MEDLINE(1966年 - 2023年9月)进行文献检索,使用的关键词为:CONCEPTT、妊娠、女性、T1D和CGM,并设置了限制条件以区分用英文撰写的人类受试者文献。迄今为止,一个被认定为CONCEPTT协作组的研究团队已经发表了17篇关于T1D孕妇使用CGM的出版物,其中包括一项主要临床试验和15项亚分析。虽然孕产妇护理的进步使母婴妊娠更安全,但患有T1D的孕妇在短期和长期内仍有较高的并发症发生率。直到最近,CGM在妊娠中的应用才得到广泛研究。CONCEPTT临床试验是一项具有里程碑意义的研究,涉及多项亚分析。主要试验证明,T1D孕妇使用CGM可降低孕晚期的高血糖水平,减少大于胎龄儿(LGA,>第90百分位数),减少新生儿重症监护病房入住时间超过24小时的情况,并减少新生儿低血糖。尽管亚分析显示了各种结果,包括由于缺乏预先设定而“无定论”,但人们认为妊娠期间T1D患者使用CGM值得推荐,并可用于改善总体结局。

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