Glucose variability in diabetic pregnancy

Area of Science:

• Endocrinology
• Maternal-Fetal Medicine
• Diabetology

Background:

• Fetal overgrowth is a significant complication in pregnancies affected by gestational diabetes mellitus (GDM) and pregestational diabetes.
• Managing diabetes during pregnancy is critical for both maternal and fetal health outcomes.

Purpose of the Study:

• To investigate the correlation between maternal glucose profiles and fetal growth parameters in pregnant women with type 1 diabetes and GDM.
• To identify specific glycemic variability metrics associated with fetal overgrowth.

Main Methods:

• Continuous glucose monitoring (CGM) was used to assess maternal glucose profiles across pregnancy trimesters in 80 women (32 type 1 diabetes, 31 GDM, 17 controls).
• Key glycemic variability parameters analyzed included mean amplitude of glycemic excursion, mean glycemia, CONGA, SD, HBGI, and IQR.
• Fetal growth was assessed using birth weight and ponderal index.

Main Results:

• Women with diabetes (type 1 and GDM) had higher prepregnancy body mass index compared to controls.
• While not statistically significant, newborns of mothers with diabetes exhibited higher mean birth weight and ponderal index.
• Specific glucose metrics, including HBGI, CONGA, IQR, mean glycemia, and SD, showed correlations with fetal ponderal index in both type 1 diabetes and GDM groups during different trimesters.

Conclusions:

• Fetal exposure to glycemic variability and hyperglycemia plays a role in the development of fetal overgrowth in diabetic pregnancies.
• Achieving optimal glucose control and minimizing glucose variability early in pregnancy is essential for preventing fetal overgrowth in women with type 1 diabetes and GDM.