Abstract
Continuous glucose monitoring (CGM) might be an effective tool to improve glycemic control in gestational diabetes mellitus (GDM). Few data are available about its utilization as a diagnostic tool to find potential alterations of glycemia in subjects with normal oral glucose tolerance test (OGTT). In this preliminary prospective real-life observational study, we aimed to analyze the glycemic pattern in normal and gestational diabetes mellitus (GDM) women by continuous glucose monitoring (CGM) in order to detect potential differences between the two groups and glycemic alterations despite a normal OGTT. After the screening for GDM, subjects were connected to a CGM system for seven consecutive days. The areas under the curve of the first 60 minutes after each meal and 60 minutes before breakfast were analyzed. Women with normal OGTT that during CGM showed impaired glycemic values (more than 95 fasting or more than 140 one hour after meals or more than 120 two hours after meals) performed one week of self-monitoring of blood glucose (SMBG). After OGTT, 53 women considered normal and 46 affected by GDM were included. CGM parameters did not show any differences between the two groups with impaired glycemic excursions found in both groups. After CGM period, 33 women with normal OGTT showed abnormal glycemic patterns. These 33 women then performed one week of SMBG. After evaluation of one week of SMBG, 21 required diet therapy and 12 required insulin treatment and were followed until the delivery. An increase in gestational weight gain was observed in normal women with normal OGTT but this was not significant. No significant data were found regarding neonatal outcomes in the two groups of women. In conclusion, CGM use in pregnancy might help to detect glycemic fluctuations in women with normal OGTT, improving their treatment and outcomes.
Highlights
Gestational diabetes mellitus (GDM) is a complex widespread condition and is increasingly present in approximately 7.5-27.0% of all pregnancies [1]
continuous glucose monitoring (CGM) seems superior to self-monitoring of blood glucose (SMBG) in detecting hypoglycemia and hyperglycemia incidents in impaired glucose tolerance and overt gestational diabetes mellitus (GDM) in pregnancy, leading to more accurate decision-making during follow-up [19,20,21]
Concerning gestational weight gain (GWG), the greatest increase in average weight is observed in the group of women with normal oral glucose tolerance test (OGTT), but these differences do not reach a statistical significance (Figure 1)
Summary
Gestational diabetes mellitus (GDM) is a complex widespread condition and is increasingly present in approximately 7.5-27.0% of all pregnancies [1] It is defined by any degree of glucose intolerance recognized during pregnancy in women who do not have a previous diagnosis of diabetes [2, 3]. The debate has begun on the diagnostic-therapeutic management of those pregnant who do not fall under the GDM criteria, but belong to the category of hyperglycemia called “mild gestational diabetes,” in which the fetal maternal outcome is often adverse [14]. It is known that both the OGTT test at diagnosis and the self-monitoring of blood glucose during follow-up are not always reliable in terms of accuracy and reproducibility [15,16,17] For these reasons, literature data suggests the use of CGM during pregnancy [18]. CGM seems superior to SMBG in detecting hypoglycemia and hyperglycemia incidents in impaired glucose tolerance and overt GDM in pregnancy, leading to more accurate decision-making during follow-up [19,20,21]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
