ABSTRACT
Objective: To examine glycaemic variability (GV) and glycaemic
control (GC) parameters in early pregnancy with subsequent development
of gestational diabetes mellitus (GDM).
Design: Longitudinal observational study.
Setting: Pregnant women from KK Women and Children’s Hospital
in Singapore
Participants: 51 study participants in the first trimester
(9-13 weeks’ gestational), and 44 participants (18-23 weeks’ gestation)
in the second trimester of pregnancy.
Methods: Independent t-tests were used to examine the
differences in the parameters between participants who developed GDM and
those who did not.
Main outcome measure: GDM was determined at 24-30 weeks’
gestation using oral glucose tolerance test (OGTT). GV parameters
examined were, mean amplitude of glycaemic excursion (MAGE), standard
deviation of blood glucose (SDBG) and mean of daily continuous 24 h
blood glucose (MBG) and coefficient of variation (CV). GC parameters
measured were, J-Index and % time spent in glucose target ranges.
Results: In the second trimester of pregnancy, mean amplitude
of glycaemic excursions (MAGE) was significantly higher in participants
who subsequently developed GDM, compared to those who did not (mean
(SD): 3.18(0.68) vs 2.60(0.53), p=0.02). Other study parameters measured
in the second trimester of pregnancy were not significantly different
between groups. There were no significant associations between all the
GV and GC parameters determined from the CGM in the first trimester with
subsequent development of GDM (p >0.05).
Conclusion: MAGE is an important GV parameter associated to the
development of subsequent GDM in pregnant women. The findings highlight
the potential value of CGM in gestational glycaemic profiling.
Funding: Singapore Ministry of Health’s National Medical
Research Council Centre Grant NMRC/CG/C008A/2017_KKH.
Key words: Continous glucose monitoring; gestational diabetes,
mean amplitude glycaemic excursion
Tweetable abstract : #CGM use and #mean glycaemic amplitude
excursion associated with #gestational diabetes