&lt;p&gt;A Review of Research Progress on Glycemic Variability and Gestational Diabetes&lt;/p&gt;

Yu, Wenshu; Wu, Na; Li, Ling; Ouyang, Hong; Qian, Meichen; Shen, Haitao

doi:10.2147/dmso.s261486

Cited by 29 publications

(34 citation statements)

References 64 publications

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“…For example, it does not reflect other characteristics of blood glucose control such as increasing or decreasing the risk of complications. It does not reflect the acute changes of blood glucose, the range of glucose changes during day, and it can´t reflect blood GV [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Glycaemic Variability and Risk Factors of Pregnant Women with and without Gestational Diabetes Mellitus Measured by Continuous Glucose Monitoring

Gáborová

Doničová

Bačová

et al. 2021

IJERPH

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Background: The aim of the study was to compare the continuous glucose monitoring (CGM)-determined glycaemic variability (GV) of pregnant women with gestational diabetes mellitus (GDM) and without GDM (CG; control group). The secondary aim was to evaluate the association between risk factors of diabetes in pregnancy and parameters of glyceamic control. Methods: Demographic, biometric and biochemical parameters were obtained for pregnant women (20–38 years old) who after an oral glucose tolerance test were examined by 7-day continuous glucose monitoring using a iPro®2 Professional CGM. Results: The differences in GV between women with GDM and CG compared by total area under glucose curve (total AUC, (mmol·day/L) was statistically significant (p = 0.006). Other parameters of glycaemic control such as mean glucose, standard deviation, coefficient of variation, J-index, % time-above target range 7.8 mmol/L (%TAR), % time-in range 3.5–7.8 mmol/L (%TIR), time-below target range 3.5 mmol/L (%TBR), glycated haemoglobin were not significantly different in the study groups. Risk factors (a family history of diabetes, pre-pregnancy BMI, higher weight gain and age) correlated with parameters of glycaemic control. Conclusions: We found a significant difference in GV of women with and without GDM by total AUC determined from CGM. TIR metrics were close to significance. Our work points at an increased GV in relation to the risk factors of GDM. Pregnant women with risk factors have higher probability of severe GV with its consequences on maternal and fetal health state.

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Section: Discussionmentioning

confidence: 99%

Glycaemic Variability and Risk Factors of Pregnant Women with and without Gestational Diabetes Mellitus Measured by Continuous Glucose Monitoring

Gáborová

Doničová

Bačová

et al. 2021

IJERPH

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“…10 Furthermore, the clinical utility of CGM to analyze GV and GC has been well demonstrated in DM patients (type 1 and type 2) by predicting risks of DM complications. 11,12 In GDM patients, GV parameters have been reported to be significantly higher in patients with GDM than those who did not develop GDM. [13][14][15][16][17] Contrary to those studies, there have been reports of no significant differences 18 or only borderline differences 19 in GV parameters between patients with GDM and those without.…”

Section: Introductionmentioning

confidence: 99%

Glycemic Variability in Early Pregnancy May Predict a Subsequent Diagnosis of Gestational Diabetes

Quah

Tan

Lek

et al. 2022

DMSO

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This study examined the prospective association between CGM-derived glycemic variability (GV) and glycemic control (GC) parameters in the first and second trimester, with subsequent diagnosis of GDM in the early third trimester. Methods: In a longitudinal observational study, 60 study participants in the first trimester (9-13 weeks' gestation), and 53 participants (18-23 weeks' gestation) in the second trimester of pregnancy had CGM data extracted after a minimum of 8 days' wear time (up to 14 days). At 24-31 weeks' gestation, participants underwent a 75 g, 2-hour oral glucose-tolerance test as per IADPSG criteria to diagnose GDM. GV parameters examined in both first and second trimesters were mean amplitude of glycemic excursion (MAGE), standard deviation (SD), mean glucose, and coefficient of variation (CV). GC parameters measured were J-Index and percentage of time spent in glucose target ranges. Results: The first trimester SD and MAGE were significantly higher in participants subsequently diagnosed with GDM (SD adjusted median 1.31 [interquartile range 1.2-1.3] mmol/L; MAGE 3.26 [3.2-3.3] mmol/L) than those who were not (SD 1.01 [0.9-1.0] mmol/ L, MAGE 2.59 [2.4-2.6] mmol/L; p<0.05). Similarly, second trimester SD and MAGE were also significantly higher in participants subsequently diagnosed with GDM ] mmol/L; MAGE 3.32 (3.31-3.41) mmol/L) than those who were not (SD 0.99 [0.98-1.01] mmol/L, MAGE 2.42 [2.42-2.55] mmol/L; p<0.05). Associations between SD and MAGE with GDM outcomes were adjusted for prepregnancy BMI and ethnicity. There were nonsignificant trends of higher J-Index scores in the first and second trimester, higher CV in the first trimester only, and higher mean in the second trimester only in participants diagnosed with GDM. Other study parameters measured were not significantly different between groups (p>0.003). Conclusion:Our study suggests the potential value of CGM-derived SD and MAGE in early pregnancy as potential predictors of subsequent GDM diagnosis.

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“…Additionally, GDM is signi cantly related with adverse perinatal outcomes [8]. Women with GDM increased risk of hypertension, hyperbilirubinemia, coronary heart disease, preeclampsia, and cesarean section, and have a higher risk of long-term obesity and diabetes post pregnancy [9,10]. Moreover, GDM is highly concerned in certain neonatal outcomes, containing large for gestational age (LGA) infants, fetal macrosomia, preterm birth, postpartum hemorrhage, and small for gestational age (SGA) [11,12].…”

Section: Introductionmentioning

confidence: 99%

Association between second and third trimester maternal lipid profiles and adverse perinatal outcomes among women with gestational diabetes mellitus: A retrospective cohort study

Shi

Tang

Yin

2022

Preprint

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Background: Lipid metabolism disorder during pregnancy has been reported in women with gestational diabetes mellitus (GDM). However, some controversy remains regarding the relationship between maternal dyslipidemia and perinatal outcomes. The aim of this study was to investigate the association between maternal lipid levels and adverse perinatal outcomes in women with GDM. Methods: Total 1755 pregnant women with GDM who delivered between 2011–2021 were enrolled in this study. Serum samples were assayed for fasting total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels during the second and third trimesters of pregnancy. Adjusted odds ratios (AOR) and 95% confidence intervals (95 % CI) were calculated via stepwise multivariable logistic regression analysis to determine the association of lipid levels with perinatal outcomes. Results: The serum TC, TG, LDL, and HDL levels in third trimester were significantly higher than those in second trimester(p<0.001). Women with GDM had significantly higher levels of TC and TG in second and third trimesters compared with women without GDM in the same trimesters, while HDL levels decreased in women with GDM. After adjusting for confounding factors by multivariate logistic regression, every mmol/L elevation in TG levels in second and third trimesters was associated with a higher risk of caesarean section(AOR=1.241, 95% CI: 1.103–1.396, p<0.001; AOR=1.716, 95% CI: 1.556–1.921, p<0.001), large for gestational age infants (AOR=1.419, 95% CI: 1.173–2.453, p=0.001; AOR=2.011, 95% CI: 1.673–2.735, p<0.001), macrosomia (AOR=1.220, 95%CI: 1.133–1.643, p=0.005; AOR=1.891, 95% CI: 1.322–2.519, p<0.001), and neonatal unit admission (AOR=1.781, 95% CI: 1.267–2.143, p<0.001; AOR=2.052, 95% CI: 1.811–2.432, p<0.001). Additionally, every mmol/L increase in second and third trimester HDL levels was associated with decreased risk of large for gestational age infants (AOR=0.478, 95% CI: 0.329–0.879, p=0.008; AOR=0.599, 95% CI: 0.321–0.783, p=0.017) and neonatal unit admission (AOR=0.575, 95% CI: 0.311–0.722, p=0.012; AOR=0.322, 95% CI: 0.178–0.599, p=0.001). Conclusions: Among women with GDM, dyslipidemia in second and third trimesters was related to adverse perinatal outcomes, suggesting the importanceof monitoring second and third trimester lipid profiles in improving clinical outcomes in GDM pregnancies.

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<p>A Review of Research Progress on Glycemic Variability and Gestational Diabetes</p>

Cited by 29 publications

References 64 publications

Glycaemic Variability and Risk Factors of Pregnant Women with and without Gestational Diabetes Mellitus Measured by Continuous Glucose Monitoring

Glycaemic Variability and Risk Factors of Pregnant Women with and without Gestational Diabetes Mellitus Measured by Continuous Glucose Monitoring

Glycemic Variability in Early Pregnancy May Predict a Subsequent Diagnosis of Gestational Diabetes

Association between second and third trimester maternal lipid profiles and adverse perinatal outcomes among women with gestational diabetes mellitus: A retrospective cohort study

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