Law, Graham R., Alnaji, Alia, Alrefaii, Lina, Endersby, Del, Cartland, Sarah J., Gilbey, Stephen G., Jennings, Paul E., Murphy, Helen and Scott, Eleanor M. (2019) Suboptimal nocturnal glucose control is associated with large for gestational age in treated gestational diabetes. Diabetes Care, 42 (5). pp. 810-815. ISSN 0149-5992
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Abstract
OBJECTIVE: Continuous glucose monitoring (CGM) provides far greater detail about fetal exposure to maternal glucose across the 24-h day. Our aim was to examine the role of temporal glucose variation on the development of large for gestational age (LGA) infants in women with treated gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: We performed a prospective observational study of 162 pregnant women with GDM in specialist multidisciplinary antenatal diabetes clinics. Participants undertook 7-day masked CGM at 30–32 weeks’ gestation. Standard summary indices and glycemic variability measures of CGM were calculated. Functional data analysis was applied to determine differences in temporal glucose profiles. LGA was defined as birth weight ≥90th percentile adjusted for infant sex, gestational age, maternal BMI, ethnicity, and parity. RESULTS:Mean glucose was significantly higher in women who delivered an LGA infant (6.2 vs. 5.8 mmol/L, P = 0.025, or 111.6 mg/dL vs. 104.4 mg/dL). There were no significant differences in percentage time in, above, or below the target glucose range or in glucose variability measures (all P > 0.05). Functional data analysis revealed that the higher mean glucose was driven by a significantly higher glucose for 6 h overnight (0030–0630 h) in mothers of LGA infants (6.0 ± 1.0 mmol/L vs. 5.5 ± 0.8 mmol/L, P = 0.005, and 108.0 ± 18.0 mg/dL vs. 99.0 ± 14.4 mg/dL). CONCLUSIONS: Mothers of LGA infants run significantly higher glucose overnight compared with mothers without LGA. Detecting and addressing nocturnal glucose control may help to further reduce rates of LGA in women with GDM.
Item Type: | Article |
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Uncontrolled Keywords: | sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being |
Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health |
Depositing User: | LivePure Connector |
Date Deposited: | 27 Feb 2019 16:30 |
Last Modified: | 19 Oct 2023 02:22 |
URI: | https://ueaeprints.uea.ac.uk/id/eprint/70039 |
DOI: | 10.2337/dc18-2212 |
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