The association between continuous glucose metrics and adverse outcomes in individuals undergoing gestational diabetes screening

Bartal, Michal Fishel; Cornthwaite, Joy A. Ashby; Ghafir, Danna; Ward, Clara; Nazeer, Sarah; Blackwell, Sean C.; Pedroza, Claudia; Chauhan, Suneet P.; Sibai, Baha M.

doi:10.1016/j.ajog.2022.11.1177

Cited by 5 publications

(10 citation statements)

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“…CGM devices hold a significant potential not only for managing T1D but also for T2D and gestational diabetes mellitus (GDM) (92)(93)(94)(95)(96)(97)(98)(99)(100)(101)(102). This adaptability is crucial, not only for the individual patient but also for the broader diabetes community.…”

Section: Discussionmentioning

confidence: 99%

Blood glucose monitoring devices for type 1 diabetes: a journey from the food and drug administration approval to market availability

Mittal,

Koutras,

Maya

et al. 2024

Front. Endocrinol.

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Blood glucose monitoring constitutes a pivotal element in the clinical management of Type 1 diabetes (T1D), a globally escalating metabolic disorder. Continuous glucose monitoring (CGM) devices have demonstrated efficacy in optimizing glycemic control, mitigating adverse health outcomes, and augmenting the overall quality of life for individuals afflicted with T1D. Recent progress in the field encompasses the refinement of electrochemical sensors, which enhances the effectiveness of blood glucose monitoring. This progress empowers patients to assume greater control over their health, alleviating the burdens associated with their condition, and contributing to the overall alleviation of the healthcare system. The introduction of novel medical devices, whether derived from existing prototypes or originating as innovative creations, necessitates adherence to a rigorous approval process regulated by the Food and Drug Administration (FDA). Diverse device classifications, stratified by their associated risks, dictate distinct approval pathways, each characterized by varying timelines. This review underscores recent advancements in blood glucose monitoring devices primarily based on electrochemical sensors and elucidates their regulatory journey towards FDA approval. The advent of innovative, non-invasive blood glucose monitoring devices holds promise for maintaining stringent glycemic control, thereby preventing T1D-associated comorbidities, and extending the life expectancy of affected individuals.

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Section: Discussionmentioning

confidence: 99%

Blood glucose monitoring devices for type 1 diabetes: a journey from the food and drug administration approval to market availability

Mittal,

Koutras,

Maya

et al. 2024

Front. Endocrinol.

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“…With respect to screening for GDM, there have been ongoing studies to determine the optimal screening regimen, diagnostic thresholds, and the patient and provider burden associated with diagnosis. From a diagnosis standpoint, multiple recent studies have started exploring whether CGM can be used to improve diagnosis and management in cases of GDM [29 ▪ –33 ▪ ]. However, determination of optimal glycemic control as defined by CGM parameters to improve maternal and neonatal outcomes, feasibility, patient satisfaction, and cost-effectiveness of using CGM for GDM management are lacking.…”

Section: Current Research In Gestational Diabetes Mellitusmentioning

confidence: 99%

Routine screening for gestational diabetes: a review

Sarker,

Ramos

2024

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of Review Rates of gestational diabetes mellitus (GDM) throughout the world continue to increase associated with the increasing rates of obesity. Given this epidemiologic burden, the importance of proper screening, diagnosis, and management cannot be understated. This review focuses on the current screening guidelines utilized throughout the world and new data recently published regarding the most optimal screening techniques and future directions for research. Recent Findings Despite unanimous opinion that GDM warrants screening, the optimal screening regimen remains controversial. Notably, in the United States per the consensus recommendation by the American College of Obstetrics and Gynecology and the Society for Maternal-Fetal Medicine, a 2-step screening approach is often used. Recently, there have been multiple studies published that have compared the 1-step and 2-step screening process with respect to GDM incidence and perinatal outcomes. These new findings are summarized below. Summary Utilization of the 1-step screening as opposed to the 2-step screening results in an increased diagnosis of GDM without significant population level benefit in outcomes. However, these studies remain underpowered to allow for meaningful comparison of outcomes in those diagnosed with GDM.

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“…El RCGTSI detecta la hiperglicemia gestacional con mayor sensibilidad que mediante el empleo de la PTOG. Así, de 92 gestantes seguidas prospectivamente durante 10 días con el RCGTSI desde el momento que recibieron el test de 50 gramos antes de recibir la PTOG de 3 horas de duración para el diagnóstico de DMG (método de 2 pasos) , se encontró que 17 (18%) resultaron positivas 1 hora después al test de 50g con un valor ≥ 135 mg/dL y 2 casos (2.2%) fueron diagnosticadas como DMG (47) . El valor promedio individual de glucosa en 24 horas fue de 105.4 mg/dL (Rango intercuartil [RIC]: 97.4-112.4), y el coeficiente de variación individual presento una variabilidad de la glucosa, de 17.1% (RIC, 14.6-19.2).…”

Section: El Significado Del Criterio Lima Su Importancia En Futuras I...unclassified

Hyperglycemia and Pregnancy

Pacora Portella

2024

Rev Peru Investig Matern Perinat

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The HAPO study encompassed 25,505 unique pregnancies across 9 countries, which underwent a 2-hour Oral Glucose Tolerance Test (OGTT) with 75 g of glucose between weeks 24 to 32 of gestation. In 2010, the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) reported that the diagnosis of hyperglycemia in pregnancy could be established using fasting values, and 1 and 2 hours post OGTT levels associated with a 1.75 times increased risk above the average of adverse effects found in the HAPO study. These levels corresponded to fasting blood sugar ≥ 92 mg/dl, 1-hour blood sugar ≥ 180 mg/dl, and 2-hour blood sugar ≥ 153 mg/dl. Although the OGTT in the HAPO study was conducted from week 24 to 32 of pregnancy, the World Health Organization in 2013 recommended using these values for the diagnosis of hyperglycemia in pregnancy outside of this gestational period, a recommendation that was later endorsed by the International Federation of Gynecology and Obstetrics (FIGO) in 2015. However, a retrospective cohort study of 6,035 pregnancies in Peruvian women who underwent OGTT between weeks 7 to 41 of pregnancy demonstrated that several factors including the number of fetuses, gestational age, maternal age over 24 years, body mass index over 24.9 kg/m2, number of prior births, the presence of poor reproductive history, and personal or family history of cardiovascular risk diseases affected maternal blood sugar levels during pregnancy. Consequently, the Lima criteria were established, corresponding to blood sugar levels ≥ 95th percentile in 650 healthy, nulliparous women aged 18 to 24 years, with singleton pregnancies and without factors affecting maternal blood sugar. This criterion demonstrated greater sensitivity and accuracy in identifying pregnant women who underwent primary cesarean section, neonates with a weight over 4 kg, preterm neonates, neonates large for gestational age, and neonatal sepsis compared to the IADPSG criteria.

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The association between continuous glucose metrics and adverse outcomes in individuals undergoing gestational diabetes screening

Cited by 5 publications

References 0 publications

Blood glucose monitoring devices for type 1 diabetes: a journey from the food and drug administration approval to market availability

Blood glucose monitoring devices for type 1 diabetes: a journey from the food and drug administration approval to market availability

Routine screening for gestational diabetes: a review

Hyperglycemia and Pregnancy

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