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Related Concept Videos

Diabetes Mellitus: Type 2 and Gestational01:22

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Pregnancy Outcomes in Patients with Type 1 Diabetes Using Continuous Glucose Monitoring.

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Continuous glucose monitoring (CGM) improved glycemic control in type 1 diabetes (T1DM) pregnancies, but did not consistently improve clinical outcomes. Stricter CGM targets were linked to better glycemic control and fewer preterm births.

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Diabetes Mellitus Research

Background:

  • Continuous glucose monitoring (CGM) is linked to better glycemic control in type 1 diabetes (T1DM).
  • However, its impact on non-glycemic outcomes, especially in pregnancy, requires further investigation.
  • Real-world data is crucial to understand CGM's full effect in T1DM pregnancies.

Purpose of the Study:

  • To assess if CGM use in T1DM pregnancies improves glycemic and clinical outcomes in a real-world setting.
  • To compare CGM users with traditional blood glucose monitoring patients.
  • To explore the association between CGM target settings and pregnancy outcomes.

Main Methods:

  • Retrospective cohort study of 288 T1DM patients from 2016-2023.
  • Primary outcomes: mid-second trimester HbA1c < 6% and a composite of severe maternal morbidity, preeclampsia, preterm birth (<34 weeks), and diabetic ketoacidosis.
  • Multivariable logistic regression was used to calculate adjusted odds ratios (aOR).

Main Results:

  • CGM use was associated with improved mid-second trimester glycemic control (40.7% vs 17.5%, aOR 2.32).
  • No significant difference was found in the composite outcome between CGM and traditional monitoring groups (42.8% vs 49.0%, aOR 0.70).
  • Within the CGM group, stricter targets correlated with better glycemic control, reduced preterm delivery (aOR 0.16), and decreased NICU admission (aOR 0.37).

Conclusions:

  • CGM use in T1DM pregnancies improves glycemic control but does not consistently translate to better clinical outcomes.
  • Adherence to American Diabetes Association (ADA) blood glucose targets may be a critical factor.
  • Stricter CGM targets show promise for improving both glycemic control and specific clinical outcomes in T1DM pregnancies.