Demystifying Glycemic Variability in GDM Pregnancies: A Cross-Sectional Observational Study
Anamika Baghel1, Aruna Nigam1, Nidhi Gupta1
1Department of Obstetrics and Gynecology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.
Journal of Obstetrics and Gynaecology of India
|May 20, 2025
Summary
Gestational diabetes mellitus (GDM) pregnancies show high glycemic variability (GV) and altered time in range, even with drug control. These factors correlate with adverse fetomaternal outcomes.
Area of Science:
- Reproductive Endocrinology
- Metabolic Disorders
- Clinical Diagnostics
Background:
- Gestational diabetes mellitus (GDM) affects maternal and fetal health.
- Pharmacotherapy aims to control blood glucose levels in GDM.
- Apparent glycemic control may not fully represent metabolic status.
Purpose of the Study:
- To assess glycemic variability (GV) and 24-hour ambulatory glucose profile (AGP) in drug-controlled GDM pregnancies.
- To investigate the correlation between GV, AGP, and fetomaternal outcomes.
- To identify key glycemic parameters affected in GDM despite apparent control.
Main Methods:
- Cross-sectional observational study involving 40 GDM pregnancies on pharmacotherapy.
- Ambulatory glucose profile (AGP) recorded using flash glucose monitoring between 32-36 weeks of gestation.
- Analysis of 600 patient days and 58,600 glucose values.
Main Results:
- Significantly elevated GV metrics (mean amplitude of glycemic excursion, standard deviation, Continuous Overall Net Glycemic Action, High Blood Glucose Index) in GDM patients (p<0.001).
- Altered time in range observed in the GDM group (p<0.001).
- GV parameters strongly correlated with poor fetomaternal outcomes in GDM pregnancies.
Conclusions:
- High GV and altered time in range are significant findings in GDM pregnancies, irrespective of apparent blood glucose control.
- These glycemic alterations are linked to adverse fetomaternal outcomes.
- GV and time in range are crucial parameters for monitoring GDM pregnancies.
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