Continuous Glucose Monitoring in Women with Normal OGTT in Pregnancy

Abstract

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.

Continuous Glucose Monitoring for the Diagnosis of Gestational Diabetes Mellitus: A Pilot Study

“…A more recent study from Tartaglione et al applied CGM (Medtronic iPro2) to the analysis of postprandial and fasting BGL in a cohort of 99 women seven days after the OGTT [ 47 ]. Among the 53 NGT, 33 women were found to have BGL above or below the recommended thresholds and were managed with a one week of SMBG and diet.…”

“…Among the 53 NGT, 33 women were found to have BGL above or below the recommended thresholds and were managed with a one week of SMBG and diet. Twelve of these women ended up requiring insulin [ 47 ]. In this study no differences were found in average daily glucose, time spent in the different ranges by GDM and NGT women and maternal and fetal outcomes [ 47 ].…”

“…Twelve of these women ended up requiring insulin [ 47 ]. In this study no differences were found in average daily glucose, time spent in the different ranges by GDM and NGT women and maternal and fetal outcomes [ 47 ].…”

Maximizing the detection rate of hypoglycemia among preterm neonates admitted in Neonatal intensive care unit in Ethiopia, 2021

“…Because glucose freely crosses the placenta, maternal hyperglycemia associated with GDM causes elevated glucose levels in the fetus, resulting in hyperinsulinism 40,41 . Thus, frequent monitoring and evaluation of glucose levels among delivered mothers is crucial worldwide in general and in the study area in particular to reduce the burden of hypoglycemia in neonates 42,43 . Although this study attempted to explore hypoglycemia and its associated factors for the first time in the study, it has some limitations.…”

Gestational diabetes mellitus: The optimal time of delivery

“…The incidence of neonatal respiratory distress syndrome, neonatal pneumonia, neonatal hypoglycemia, and neonatal asphyxia is not significantly different between A1 GDM and normal pregnancies. Tartaglione et al [ 26 ] continuously monitored and adjusted blood glucose levels in 46 patients with GDM and 53 normal controls and found no differences in maternal and fetal outcomes between them when blood glucose levels were consistently controlled. Hochberg et al [ 27 ] compared the differences in maternal and fetal outcomes after induction of labor from 37-38 wk in 193 non-GDM patients and 39-40 wk in 237 singleton pregnant women with well-controlled GDM and found no differences between gestational week intervals.…”