Postgraduate Resident, Department of Obstetrics and Gynecology, Hamdard Institute of Medical Sciences & Research (HIMSR), Jamia Hamdard University (Deemed to be University), Delhi, India.
Professor and Head of the Department, Department of Obstetrics and Gynecology, Hamdard Institute of Medical Sciences & Research (HIMSR), Jamia Hamdard University (Deemed to be University), Delhi, India, Corresponding Author.
J Assoc Physicians India. 2023 Dec;71(12):32-35. doi: 10.59556/japi.71.0412.
Although glycemic variability (GV) has been shown to be associated with endothelial dysfunction in diabetes mellitus (DM), there is a dearth of literature on its correlation in gestational diabetic pregnancies.
To compare GV and 24-hour ambulatory glucose profile (AGP) in gestational diabetic pregnancies with and without large for gestation-age (LGA) babies.
It was a cross-sectional observational study. A total of 40 pregnant females between 19 and 35 years with gestational DM (GDM) controlled on pharmacotherapy fulfilling inclusion criteria were recruited. A flash glucose monitor (FGM) was used to record AGP between 32 and 36 weeks of gestation in these women. A total of 400 patient days with 38,400 glucose values in the study group were analyzed. Various glucose measures were compared between the GDM pregnancies with or without LGA babies.
The incidence of LGA was 15% in these pregnant women who were on pharmacotherapy and apparently controlled as evidenced by self-monitoring of blood sugar values. All the parameters of 24-hour AGP except dinner values were significantly high in the LGA group when compared with the non-LGA group [mean amplitude of glycemic excursion (MAGE) LGA vs non-LGA 74.58 ± 16.83 vs 49.86 ± 12.83 mg/dL, = 0.002; standard deviation (SD) LGA vs non-LGA 30.19 ± 9.69 vs 20.10 ± 5.97 mg/dL, = 0.001]. Variables of GV: MAGE and SD were significantly high in the LGA group ( < 0.001). Time below range (TBR) and time above range (TAR) were also significantly altered in the LGA group ( < 0.001).
High GV and time in the range are the important parameters that can be well correlated with LGA babies in gestational diabetic pregnancies on pharmacotherapy. An FGM is a good monitoring device to measure this parameter and can be used as an adjunct to modify measures to control the glucose values within range in these pregnancies.
尽管血糖变异性（GV）已被证明与糖尿病患者的内皮功能障碍有关，但关于其在妊娠期糖尿病中的相关性的文献却很少。
比较伴有和不伴有巨大儿（LGA）的妊娠期糖尿病患者的 GV 和 24 小时动态血糖谱（AGP）。
这是一项横断面观察性研究。共招募了 40 名年龄在 19 至 35 岁之间、接受药物治疗的妊娠期糖尿病（GDM）且符合纳入标准的孕妇。在这些女性中，使用瞬态葡萄糖监测仪（FGM）记录 32 至 36 周的 AGP。研究组共分析了 400 个患者日的 38400 个血糖值。比较了 GDM 妊娠中伴有和不伴有 LGA 婴儿的各种血糖指标。
在接受药物治疗且显然通过自我监测血糖值得到控制的孕妇中，LGA 的发生率为 15%。与非 LGA 组相比，LGA 组的 24 小时 AGP 所有参数（除晚餐值外）均显著升高[平均血糖波动幅度（MAGE）LGA 与非 LGA 分别为 74.58 ± 16.83 与 49.86 ± 12.83 mg/dL， = 0.002；标准差（SD）LGA 与非 LGA 分别为 30.19 ± 9.69 与 20.10 ± 5.97 mg/dL， = 0.001]。GV 相关变量：MAGE 和 SD 在 LGA 组中显著升高（ < 0.001）。TBR 和 TAR 也在 LGA 组中发生显著改变（ < 0.001）。
高血糖变异性和时间在范围内是重要的参数，可与药物治疗的妊娠期糖尿病中伴有 LGA 婴儿良好相关。FGM 是一种很好的监测设备，可以测量该参数，并可作为辅助手段，以控制这些妊娠期间的血糖值在范围内。
