Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Diabetes Care. 2024 Nov 1;47(11):1916-1921. doi: 10.2337/dc24-0944.
We explored the potential value of continuous glucose monitoring (CGM) in early pregnancy in predicting gestational diabetes mellitus (GDM) and pregnancy outcomes.
The study recruited 103 multiethnic Asian pregnant women with overweight or obesity from a hospital-based, prospective cohort. All of them had worn blinded CGM devices in early pregnancy and underwent the universal GDM screening at 24-28 gestation weeks. Models were selected based on early pregnancy risk factors and CGM-derived parameters to compare their respective predictive values for GDM and pregnancy outcomes.
Eighteen GDM cases were ascertained. CGM-derived novel parameters demonstrated greater performance (e.g., area under the curve: 0.953 vs. 0.722) for predicting incident GDM compared with the model using traditional risks. Such novel CGM-derived parameters significantly differentiated primary cesarean and large-for-gestational age babies.
Our data suggest CGM's potential clinical utility in the first trimester for predicting GDM and adverse pregnancy outcomes, particularly in individuals with overweight or obesity.
本研究旨在探讨妊娠早期连续血糖监测（CGM）在预测妊娠期糖尿病（GDM）及妊娠结局方面的潜在价值。
本研究纳入了 103 名来自医院前瞻性队列的超重或肥胖的多民族亚裔孕妇。所有孕妇在妊娠早期均佩戴盲法 CGM 设备，并在 24-28 孕周进行了常规 GDM 筛查。基于妊娠早期的危险因素和 CGM 衍生参数建立模型，比较它们对 GDM 和妊娠结局的预测价值。
共确诊了 18 例 GDM 病例。与使用传统风险因素的模型相比，CGM 衍生的新型参数在预测新发 GDM 方面具有更好的性能（例如，曲线下面积：0.953 比 0.722）。这些新型 CGM 衍生参数可显著区分初次剖宫产分娩和巨大儿。
本研究数据提示，CGM 在预测 GDM 和不良妊娠结局方面具有一定的临床应用价值，尤其适用于超重或肥胖的个体。在妊娠早期使用 CGM 可能有助于更准确地识别具有 GDM 风险的孕妇，并采取相应的干预措施以改善母婴结局。
