Continuous Glucose Monitoring in Pregnancy: Importance of Analysing Temporal Profiles to Understand Clinical Outcomes

Scott, Eleanor M., Feig, Denice S., Murphy, Helen R. and Law, Graham R. (2020) Continuous Glucose Monitoring in Pregnancy: Importance of Analysing Temporal Profiles to Understand Clinical Outcomes. Diabetes Care, 43 (6). pp. 1178-1184. ISSN 0149-5992

Full content URL: https://doi.org/10.2337/DC19-2527

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Continuous Glucose Monitoring in Pregnancy: Importance of Analysing Temporal Profiles to Understand Clinical Outcomes
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Abstract

Objective: To determine if temporal glucose profiles differed between: 1) women who were
randomized to continuous glucose monitoring (RT-CGM) or self-monitored blood glucose
(SMBG); 2) women who used insulin pumps or multiple daily injections (MDI); 3) women
whose infants were born large for gestational age (LGA) or not, by assessing CGM data
obtained from the CONCEPTT trial.
Research Design and Methods: Standard summary metrics and functional data analysis
(FDA) were applied to CGM data from the CONCEPTT trial (n=100 CGM; n=100 SMBG)
taken at baseline, 24 and 34 weeks gestation. Multivariable regression analysis determined if
temporal differences in 24 hour glucose profiles occurred between comparators in each of the
three groups.
Results – FDA revealed that women using RT-CGM had significantly lower glucose [0.4-0.8
mmol/l (7-14mg/dL)] for 7 hrs/day (08.00-12.00 and 16.00-19.00) compared to SMBG.
Women using pumps had significantly higher glucose [0.4-0.9 mmol/l (7-16mg/dL)] for 12
hrs/day (03.00 - 06.00, 13.00-18.00 and 20.30-00.30) at 24 weeks with no difference at 34
weeks compared to MDI. Women who had an LGA infant ran a significantly higher glucose
by 0.4-0.7 mmol/l (7-13 mg/dL) for 4.5 hrs/day at baseline; by 0.4-0.9 mmol/l (7-16 mg/dL)
for 16 hrs/day at 24 weeks; and by 0.4-0.7mmol/l (7-13 mg/dL) for 14 hrs/day at 34 weeks.
Conclusions: FDA of temporal glucose profiles gives important information about
differences in glucose control and its timing, undetectable by standard summary metrics.
Women using RT-CGM were able to achieve better daytime glucose control reducing fetal
exposure to maternal glucose.

Keywords:Diabetes, birthweight, circadian
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Social Science > School of Health & Social Care
ID Code:40199
Deposited On:30 Mar 2020 14:21

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