Suboptimal Nocturnal Glucose Control Is Associated With Large for Gestational Age in Treated Gestational Diabetes Mellitus
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 mellitu...
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| Veröffentlicht in: | Diabetes care 2019-05, Vol.42 (5), p.810-815 |
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| creator | Law, Graham R Alnaji, Alia Alrefaii, Lina Endersby, Del Cartland, Sarah J Gilbey, Stephen G Jennings, Paul E Murphy, Helen R Scott, Eleanor M |
| description | 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).
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.
Mean glucose was significantly higher in women who delivered an LGA infant (6.2 vs. 5.8 mmol/L,
= 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
> 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,
= 0.005, and 108.0 ± 18.0 mg/dL vs. 99.0 ± 14.4 mg/dL).
Mothers of LGA infants run significantly higher glucose overnight compared with mothers without LGA infants. Detecting and addressing nocturnal glucose control may help to further reduce rates of LGA in women with GDM. |
| doi_str_mv | 10.2337/dc18-2212 |
| format | Article |
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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.
Mean glucose was significantly higher in women who delivered an LGA infant (6.2 vs. 5.8 mmol/L,
= 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
> 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,
= 0.005, and 108.0 ± 18.0 mg/dL vs. 99.0 ± 14.4 mg/dL).
Mothers of LGA infants run significantly higher glucose overnight compared with mothers without LGA infants. Detecting and addressing nocturnal glucose control may help to further reduce rates of LGA in women with GDM.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc18-2212</identifier><identifier>PMID: 30765428</identifier><language>eng</language><publisher>United States: American Diabetes Association</publisher><subject>Adolescent ; Adult ; Age ; Birth weight ; Birth Weight - physiology ; Blood Glucose - metabolism ; Blood Glucose Self-Monitoring ; Body mass ; Circadian Rhythm - physiology ; Data analysis ; Diabetes ; Diabetes mellitus ; Diabetes, Gestational - blood ; Diabetes, Gestational - diagnosis ; Diabetes, Gestational - epidemiology ; Diabetes, Gestational - therapy ; Disease control ; Female ; Fetal Macrosomia - blood ; Fetal Macrosomia - epidemiology ; Fetal Macrosomia - etiology ; Fetuses ; Gestation ; Gestational Age ; Gestational diabetes ; Glucose ; Glucose monitoring ; Glucose Tolerance Test ; Humans ; Infant ; Infant, Newborn ; Infants ; Male ; Maternal & child health ; Middle Aged ; Minority & ethnic groups ; Pregnancy ; Prenatal exposure ; Prospective Studies ; Research design ; Variability ; Young Adult</subject><ispartof>Diabetes care, 2019-05, Vol.42 (5), p.810-815</ispartof><rights>2019 by the American Diabetes Association.</rights><rights>Copyright American Diabetes Association May 1, 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c348t-99794569b892d63b817ab652ca7a31ad7a4dcc82611144b266d2caf2dbb34da33</citedby><cites>FETCH-LOGICAL-c348t-99794569b892d63b817ab652ca7a31ad7a4dcc82611144b266d2caf2dbb34da33</cites><orcidid>0000-0001-5395-8261</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30765428$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Law, Graham R</creatorcontrib><creatorcontrib>Alnaji, Alia</creatorcontrib><creatorcontrib>Alrefaii, Lina</creatorcontrib><creatorcontrib>Endersby, Del</creatorcontrib><creatorcontrib>Cartland, Sarah J</creatorcontrib><creatorcontrib>Gilbey, Stephen G</creatorcontrib><creatorcontrib>Jennings, Paul E</creatorcontrib><creatorcontrib>Murphy, Helen R</creatorcontrib><creatorcontrib>Scott, Eleanor M</creatorcontrib><title>Suboptimal Nocturnal Glucose Control Is Associated With Large for Gestational Age in Treated Gestational Diabetes Mellitus</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>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).
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.
Mean glucose was significantly higher in women who delivered an LGA infant (6.2 vs. 5.8 mmol/L,
= 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
> 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,
= 0.005, and 108.0 ± 18.0 mg/dL vs. 99.0 ± 14.4 mg/dL).
Mothers of LGA infants run significantly higher glucose overnight compared with mothers without LGA infants. Detecting and addressing nocturnal glucose control may help to further reduce rates of LGA in women with GDM.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Birth weight</subject><subject>Birth Weight - physiology</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Glucose Self-Monitoring</subject><subject>Body mass</subject><subject>Circadian Rhythm - physiology</subject><subject>Data analysis</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes, Gestational - blood</subject><subject>Diabetes, Gestational - diagnosis</subject><subject>Diabetes, Gestational - epidemiology</subject><subject>Diabetes, Gestational - therapy</subject><subject>Disease control</subject><subject>Female</subject><subject>Fetal Macrosomia - blood</subject><subject>Fetal Macrosomia - epidemiology</subject><subject>Fetal Macrosomia - etiology</subject><subject>Fetuses</subject><subject>Gestation</subject><subject>Gestational Age</subject><subject>Gestational diabetes</subject><subject>Glucose</subject><subject>Glucose monitoring</subject><subject>Glucose Tolerance Test</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Male</subject><subject>Maternal & child health</subject><subject>Middle Aged</subject><subject>Minority & ethnic groups</subject><subject>Pregnancy</subject><subject>Prenatal exposure</subject><subject>Prospective Studies</subject><subject>Research design</subject><subject>Variability</subject><subject>Young Adult</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkctOwzAQRS0EoqWw4AeQJTawCPiVxF5WBUqlAguKWEZ-FVKldbGdBXw9TlsQYuWR58yd0b0AnGJ0RSgtr43GPCMEkz3Qx4LmWZ4zvg_6CDOR5UKQHjgKYYEQYozzQ9CjqCxyRngffD23yq1jvZQNfHQ6tn6VqnHTahcsHLlV9K6BkwCHIThdy2gNfK3jO5xK_2bh3Hk4tiHKWLtucJj-6hWcebsh_7ZuaqlstAE-2KapYxuOwcFcNsGe7N4BeLm7nY3us-nTeDIaTjNNGY-ZEKVgeSEUF8QUVHFcSlXkRMtSUixNKZnRmpMCY8yYIkVhUm9OjFKUGUnpAFxsddfefbTpompZB52OkCvr2lAl4yhOCxBK6Pk_dOE2jnQUYZQhyjvqcktp70Lwdl6tfTLQf1YYVV0gVRdIp0sSe7ZTbNXSml_yJwH6DU03hcY</recordid><startdate>201905</startdate><enddate>201905</enddate><creator>Law, Graham R</creator><creator>Alnaji, Alia</creator><creator>Alrefaii, Lina</creator><creator>Endersby, Del</creator><creator>Cartland, Sarah J</creator><creator>Gilbey, Stephen G</creator><creator>Jennings, Paul E</creator><creator>Murphy, Helen R</creator><creator>Scott, Eleanor M</creator><general>American Diabetes Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5395-8261</orcidid></search><sort><creationdate>201905</creationdate><title>Suboptimal Nocturnal Glucose Control Is Associated With Large for Gestational Age in Treated Gestational Diabetes Mellitus</title><author>Law, Graham R ; Alnaji, Alia ; Alrefaii, Lina ; Endersby, Del ; Cartland, Sarah J ; Gilbey, Stephen G ; Jennings, Paul E ; Murphy, Helen R ; Scott, Eleanor M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-99794569b892d63b817ab652ca7a31ad7a4dcc82611144b266d2caf2dbb34da33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Birth weight</topic><topic>Birth Weight - physiology</topic><topic>Blood Glucose - metabolism</topic><topic>Blood Glucose Self-Monitoring</topic><topic>Body mass</topic><topic>Circadian Rhythm - physiology</topic><topic>Data analysis</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes, Gestational - blood</topic><topic>Diabetes, Gestational - diagnosis</topic><topic>Diabetes, Gestational - epidemiology</topic><topic>Diabetes, Gestational - therapy</topic><topic>Disease control</topic><topic>Female</topic><topic>Fetal Macrosomia - blood</topic><topic>Fetal Macrosomia - epidemiology</topic><topic>Fetal Macrosomia - etiology</topic><topic>Fetuses</topic><topic>Gestation</topic><topic>Gestational Age</topic><topic>Gestational diabetes</topic><topic>Glucose</topic><topic>Glucose monitoring</topic><topic>Glucose Tolerance Test</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Male</topic><topic>Maternal & child health</topic><topic>Middle Aged</topic><topic>Minority & ethnic groups</topic><topic>Pregnancy</topic><topic>Prenatal exposure</topic><topic>Prospective Studies</topic><topic>Research design</topic><topic>Variability</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Law, Graham R</creatorcontrib><creatorcontrib>Alnaji, Alia</creatorcontrib><creatorcontrib>Alrefaii, Lina</creatorcontrib><creatorcontrib>Endersby, Del</creatorcontrib><creatorcontrib>Cartland, Sarah J</creatorcontrib><creatorcontrib>Gilbey, Stephen G</creatorcontrib><creatorcontrib>Jennings, Paul E</creatorcontrib><creatorcontrib>Murphy, Helen R</creatorcontrib><creatorcontrib>Scott, Eleanor M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Law, Graham R</au><au>Alnaji, Alia</au><au>Alrefaii, Lina</au><au>Endersby, Del</au><au>Cartland, Sarah J</au><au>Gilbey, Stephen G</au><au>Jennings, Paul E</au><au>Murphy, Helen R</au><au>Scott, Eleanor M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Suboptimal Nocturnal Glucose Control Is Associated With Large for Gestational Age in Treated Gestational Diabetes Mellitus</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2019-05</date><risdate>2019</risdate><volume>42</volume><issue>5</issue><spage>810</spage><epage>815</epage><pages>810-815</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><abstract>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).
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.
Mean glucose was significantly higher in women who delivered an LGA infant (6.2 vs. 5.8 mmol/L,
= 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
> 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,
= 0.005, and 108.0 ± 18.0 mg/dL vs. 99.0 ± 14.4 mg/dL).
Mothers of LGA infants run significantly higher glucose overnight compared with mothers without LGA infants. Detecting and addressing nocturnal glucose control may help to further reduce rates of LGA in women with GDM.</abstract><cop>United States</cop><pub>American Diabetes Association</pub><pmid>30765428</pmid><doi>10.2337/dc18-2212</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-5395-8261</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Age Birth weight Birth Weight - physiology Blood Glucose - metabolism Blood Glucose Self-Monitoring Body mass Circadian Rhythm - physiology Data analysis Diabetes Diabetes mellitus Diabetes, Gestational - blood Diabetes, Gestational - diagnosis Diabetes, Gestational - epidemiology Diabetes, Gestational - therapy Disease control Female Fetal Macrosomia - blood Fetal Macrosomia - epidemiology Fetal Macrosomia - etiology Fetuses Gestation Gestational Age Gestational diabetes Glucose Glucose monitoring Glucose Tolerance Test Humans Infant Infant, Newborn Infants Male Maternal & child health Middle Aged Minority & ethnic groups Pregnancy Prenatal exposure Prospective Studies Research design Variability Young Adult |
| title | Suboptimal Nocturnal Glucose Control Is Associated With Large for Gestational Age in Treated Gestational Diabetes Mellitus |
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