The 24-hour excursion and diurnal rhythm of glucose, insulin, and C-peptide in normal pregnancy

Cousins, Larry; Rigg, Lee A.; Hollingsworth, Dorothy R.; Brink, G.; Aurand, Jill; Yen, S. S. C.

doi:10.1016/0002-9378(80)90675-4

Cited by 123 publications

(50 citation statements)

References 20 publications

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“…When we further analyzed the ambulatory glycemic profile, we found no difference in preprandial values throughout the day and significantly lower mean blood glucose levels during nighttime (2300 to 0600 h) in comparison to daytime (Table 1). These findings are lower than some have previously reported (10,11) but in agreement with others (13). Thus, our data may provide the characterization of glycemic profile in the second half of pregnancy, which would inform the level of glycemia to be targeted to mirror normoglycemia in the pregnant diabetic subject.…”

Section: Diurnal Glycemic Profile In Nondiabeticsupporting

confidence: 87%

Goals of Metabolic Management of Gestational Diabetes

Hod

Yogev

2007

Diabetes Care

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Section: Diurnal Glycemic Profile In Nondiabeticsupporting

confidence: 87%

Goals of Metabolic Management of Gestational Diabetes

Hod

Yogev

2007

Diabetes Care

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“…Although there is overwhelming evidence that good perinatal outcomes can be achieved in diabetic pregnancies only with the normalization of maternal glucose values (4 -6), there is no clear definition of normoglycemia in nondiabetic pregnancies. In fact, a very limited number of studies have been performed thus far in the attempt to define maternal glucose levels in normal pregnancies; moreover, these studies involved small series of hospitalized subjects and considered only glycemic values collected during a single day in the third trimester (7)(8)(9)(10).…”

Section: Diabetes Care 24:1319 -1323 2001mentioning

confidence: 99%

Third-Trimester Maternal Glucose Levels From Diurnal Profiles in Nondiabetic Pregnancies

et al. 2001

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OBJECTIVE -To assess the 24-h glucose levels in a group of nondiabetic, nonobese pregnant women and to verify the presence of correlations between maternal glucose levels and sonographic parameters of fetal growth. RESEARCH DESIGN AND METHODS -A total of 66Caucasian nonobese pregnant women with normal glucose challenge tests (GCT) enrolled in the study; from this population, we selected 51 women who delivered term (from 37 to 42 weeks completed) live-born infants without evidence of congenital malformations. The women were requested to have three main meals and to perform daily glucose profiles fortnightly from 28 -38 weeks without modifying their lifestyle or following any dietary restriction. All subjects were taught how to monitor their blood glucose by using a reflectance meter. Fetal biometry was evaluated by ultrasound scan according to standard methodology at 22, 28, 32, and 36 weeks of pregnancy.RESULTS -The overall daily mean glucose level during the third trimester was 74.7 Ϯ 5.2 mg/dl. Daily mean glucose values increased between 28 (71.9 Ϯ 5.7 mg/dl) and 38 (78.3 Ϯ 5.4 mg/dl) weeks of pregnancy. We found a significant positive correlation at 28 weeks between 1-h postprandial glucose values and fetal abdominal circumference (AC). At 32 weeks, we documented positive correlations between fetal AC and maternal blood glucose levels 1 h after breakfast, 1 and 2 h after lunch, and 1 and 2 h after dinner. At 36 weeks, there was a positive correlation between fetal AC and 1-and 2-h postprandial blood glucose levels. In addition, there was a negative correlation between head-abdominal circumference ratio and 1-h postprandial blood glucose values.CONCLUSIONS -This longitudinal study first provides a contribution toward the definition of normoglycemia in nondiabetic, nonobese pregnant women; moreover, it reveals significant correlations of postprandial blood glucose levels with the growth of insulin-sensitive fetal tissues and, in particular, between 1-h postprandial blood glucose values and fetal AC. Diabetes Care 24:1319 -1323, 2001T he complex phenomenon of fetal growth has been thoroughly investigated over past decades (1) but still remains to be fully understood. We know that maternal glucose is one of the most important factors of influence (1,2), and Reece et al. (3) showed that normoglycemia in pregnancy is associated with normal levels of other nutrients, such as amino acids and lipids. For this reason, glycemia is the single maternal metabolic parameter routinely assessed in diabetic pregnancies. Indeed, the criteria for metabolic control and therapeutic strategies of diabetes in pregnancy are based almost exclusively on maternal glucose levels (2). Although there is overwhelming evidence that good perinatal outcomes can be achieved in diabetic pregnancies only with the normalization of maternal glucose values (4 -6), there is no clear definition of normoglycemia in nondiabetic pregnancies. In fact, a very limited number of studies have been performed thus far in the attempt to define maternal glucose l...

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“…Gebeliğin ilk trimestrindeki düşük HbA1c düze-yi; düşük ortalama açlık ve tokluk kan şekeri değerleri ve genç eritrositlerdeki artış ile açıklanabilir [25]. Gebeliğin üçüncü trimestrindeki artış ise yüksek ortalama tokluk kan şekeri değerleri ile açıklanabilir [26]. Bizim çalışma-mızda HbA1c açısından istatistiksel olarak anlamlı fark diyabetik gebe, nondiyabetik gebe, kontrol grubu veya trimestrlere göre incelemelerin hiçbirinde bulunmamıştır.…”

Section: Gereç Ve Yöntemunclassified

“…Hastanemiz kadın hastalıkları ve doğum kliniğinde gestasyonel diyabet (GDM) taraması için ADA kriterlerinin iki aşamalı yaklaşımına benzer şekilde [14] gebelere rutin olarak [24][25][26][27][28]. haftalarda 50 gr.…”

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Importance of HbA1c and Fructosamine As A Marker Of Glycemic Control and Evaluation Of Some Biochemical Parameters During Pregnancy

Seker¹,

Özdemir²,

Çağlar³

et al. 2014

Turk J Bioch

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Objective: Controlling and monitoring the diabetes during pregnancy, because of the malformation, macrosomia and other complications is especially important. Our study is designed to investigate the reliability of the two most commonly used parameter is the hemoglobin A1c (HbA1c) and fructosamine during pregnancy. Also among our study group, serum total protein, albumin, vitamin B12, folic acid, glucose, insulin, ferritin and hemoglobin data were evaluated. Methods: The study groups are pregnant women (n=252; age mean: 27,761± 5/year) and control group (n=28; age mean: 28,61± 5,38/year) who are no additional health problems. Diabetic pregnant women number is 124 (consisted of 10 first trimester, 62 second trimester and 52 third trimester) and nondiabetic pregnant women number is 138 (consisted of 24 first trimester, 32 second trimester and 82 third trimester). All measurement data are obtained from hospital information system. Results: No statistically significant difference in any of the groups for HbA1c. It's clearly observed that all the significant differences found for fructosamine occur depending on the level of albumin and fructosamine levels decreased progressively during the three trimesters. In our diabetic pregnant women group; although statistically make a difference; mean blood glucose values were below our expectations. Conclusion: Our study is support that fructosamine and HbA1c are unavailable for diagnosis and monitoring the gestational diabetes. However the lack of difference between the groups for levels of fructosamine and HbA1c; and blood glucose levels below our expectations in diabetic pregnant women group can be connected good diabetes control. Key Words: Pregnancy, fructosamine, HbA1c, glycemic control Conflict of Interest: The authors declare no conflict of interest. ÖZETAmaç: Diyabetin kontrol ve monitorizasyonu fetal malformasyon, makrozomi ve diğer komplikasyonlar nedeniyle gebelikte özellikle önemlidir. Çalışmamız, monitorizasyonda en sık kullanılan iki parametre olan hemoglobin A1c (HbA1c) ve fruktozaminin gebelik döneminde güvenilirliğinin araştırılması amacıyla tasarlanmış; ayrıca çalışma gruplarımızda serum total protein, albümin, vitamin B12, folat, glukoz, insülin, ferritin ve hemoglobin verileri de değer-lendirilmiştir. Metod: Çalışma grupları; ek sağlık problemi olmayan gebeler (n=252; ort. yaş: 27,761± 5/ yıl) ve kontrol grubu (n=28; ort. yaş: 28,61± 5,38/yıl)'ndan oluşmuştur. Diyabetik gebe grubu 124 (10'u ilk, 62'si ikinci ve 52'si üçüncü trimestrde); nondiyabetik gebe grubu ise 138 kişiden (24'ü ilk, 32'si ikinci ve 82'si üçüncü trimestrde) oluşmuştur. Bütün ölçüm verileri hastane bilgi sisteminden sağlanmıştır. Bulgular: Grupların hiçbirinde HbA1c için istatistiksel olarak anlamlı fark bulunamamıştır. Fruktozamin için bulunan anlamlı farkların da albümine bağlı olarak oluştuğu net olarak görül-müş ve fruktozamin düzeyleri trimestrler boyunca progresif olarak azalmıştır. Diyabetik gebe grubumuzda elde ettiğimiz ortalama kan şekeri değeri diğer gruplara kıyasla is...

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The 24-hour excursion and diurnal rhythm of glucose, insulin, and C-peptide in normal pregnancy

Cited by 123 publications

References 20 publications

Goals of Metabolic Management of Gestational Diabetes

Goals of Metabolic Management of Gestational Diabetes

Third-Trimester Maternal Glucose Levels From Diurnal Profiles in Nondiabetic Pregnancies

Importance of HbA1c and Fructosamine As A Marker Of Glycemic Control and Evaluation Of Some Biochemical Parameters During Pregnancy

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