scholarly journals Continuous Glucose Monitoring in Patients with Abnormal Glucose Tolerance during Pregnancy: A Case Series

2016 ◽  
Vol 7 ◽  
pp. JCM.S34825 ◽  
Author(s):  
Mie Tonoike ◽  
Miyako Kishimoto ◽  
Mayumi Yamamoto ◽  
Tetsu Yano ◽  
Mitsuhiko Noda
Keyword(s):  
Glycemic Control ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
Glucose Intolerance ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Case Series ◽  
Postprandial Hyperglycemia ◽  
Abnormal Glucose Tolerance ◽  
Glucose Fluctuations

Abnormal glucose tolerance during pregnancy is associated with perinatal complications. We used continuous glucose monitoring (CGM) in pregnant women with glucose intolerance to achieve better glycemic control and to evaluate the maternal glucose fluctuations. We also used CGM in women without glucose intolerance (the control cases). Furthermore, the standard deviation (SD) and mean amplitude of glycemic excursions (MAGE) were calculated for each case. For the control cases, the glucose levels were tightly controlled within a very narrow range; however, the SD and MAGE values in pregnant women with glucose intolerance were relativity high, suggesting postprandial hyperglycemia. Our results demonstrate that pregnant women with glucose intolerance exhibited greater glucose fluctuations compared with the control cases. The use of CGM may help to improve our understanding of glycemic patterns and may have beneficial effects on perinatal glycemic control, such as the detection of postprandial hyperglycemia in pregnant women.

scholarly journals Abnormal glucose tolerance in children with cystic fibrosis: the predictive role of continuous glucose monitoring system

2010 ◽  
Vol 162 (4) ◽  
pp. 705-710 ◽  
Author(s):  
Riccardo Schiaffini ◽  
Claudia Brufani ◽  
Beatrice Russo ◽  
Danilo Fintini ◽  
Antonella Migliaccio ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Glucose Metabolism ◽  
Glucose Tolerance ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Continuous Glucose Monitoring System ◽  
Abnormal Glucose Tolerance ◽  
Altered Glucose

A long pre-diabetic phase of abnormal glucose tolerance is described in subjects with cystic fibrosis (CF) since childhood.ObjectiveThe aims of the study were to compare oral glucose tolerance test (OGTT) and continuous glucose monitoring system (CGMS) in the diagnosis of altered glucose metabolism, and to longitudinally evaluate the role of CGMS in predicting glucose metabolism deterioration in children with CF.MethodsSeventeen children with CF and 14 controls were enrolled (mean age 13.3±3.0 years). All subjects underwent OGTT and CGMS registration. On the basis of OGTT, children were classified as normal glucose tolerance, impaired glucose tolerance (IGT), IGT plus at least one glucose value above 200 mg/dl at intermediate OGTT points (IGT+200) and CF-related diabetes (CFRD). HbA1c, glucose area under the curve, insulin sensitivity, and insulinogenic and disposition indexes were also considered. Subjects with CF underwent another OGTT after 2.5 years.ResultsBaseline OGTT revealed 3/17 (7.6%) children with CF with at least one glucose value above 200 mg/dl (1 CFRD and 2 IGT+200), while CGMS revealed 6/17 (35.3%) children with glucose excursions above 200 mg/dl (P=0.010). None of the controls showed glucose over 200 mg/dl either at OGTT or at CGMS. At the 2.5-year follow-up OGTT, all the six subjects who had diabetic glucose excursion (i.e. >200 mg/dl) at baseline CGMS presented IGT+200 or CFRD. In logistic regression analysis, CGMS diabetic excursion was the strongest predictor of IGT+200 and CFRD (P<0.001).ConclusionsCGMS could be a useful tool to predict glucose metabolism derangements in children affected by CF.

scholarly journals Flash glucose monitoring in gestational diabetes mellitus: possibilities for assessing glycemic variability

2021 ◽  
pp. 414-419
Author(s):  
F. O. Ushanova ◽  
T. Yu. Demidova ◽  
M. Ya. Izmaylova
Keyword(s):  
Glycemic Control ◽  
Pregnant Women ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Blood Glucose Monitoring ◽  
Freestyle Libre ◽  
Glycemic Profile ◽  
Glycemic Monitoring

Introduction. Blood glucose monitoring is critical in maintaining glycemic control in women with GDM and in reducing adverse maternal and fetal outcomes. One of the tools that can help achieve optimal glycemic control during pregnancy is continuous glucose monitoring, which empowers clinicians to assess the characteristics of daily glycemic variability.The aim. Compare biweekly glycemic profiles and glycemic variability in pregnant women with GDM and in healthy pregnant women using the FreeStyle Libre flash glycemic monitoring system.Materials and methods. Analysis of the glycemic profile of 49 pregnant women aged 33.2 ± 6.1 years. The average gestational age of the women included in the study was 12.6 ± 6.4 weeks. Pregnant women were divided into 2 groups: 37 pregnant women with GDM and 12 healthy pregnant women. Each group underwent two-week glucose profile monitoring using the FreeStyle Libre continuous monitoring system. Statistical analysis was carried out using Microsoft Office Excel 2016, STATISTICA 10 programs (developed by StatSoft.Inc), EasyGV, version 9.Results. The average glycemic level in the groups was 4.724 ± 0.37 mmol/L vs 4.24 ± 0.34 mmol/L, respectively (p˂0.001). Comparative analysis of GV parameters in groups of pregnant women with and without GDM: SD – 0.908 vs 0.7213 (p˂0.05); LI – 1.5 vs 0.8 (p˂0.05); HBGI – 0.503 vs 0.42 (p˂0.05); J-index – 10.343 vs 7.9870 (p˂0.001); MOOD – 0.956 vs 0.7992 (p˂0.05); MAGE  – 2.326  vs 1.8042  (p˂0.05); ADDR  – 2.216  vs 0.4210  (p˂0.05); MAG  – 4.612  vs 2.6163  (p˂0.001), respectively. The CONGA index did not show a statistically significant difference in both groups: 3.95 vs 3.7 (p = 0.5).Conclusions. Flash-glycemic monitoring can be used to obtain more detailed information about the glycemic profile, especially when it is difficult to assess the degree of GDM compensation. Continuous glucose monitoring can facilitate the optimization of glycemic control and provide a basis for treatment decisions. 

scholarly journals Continuous glucose monitoring in obese pregnant women with no hyperglycemia on glucose tolerance test

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253047
Author(s):  
Rosa Maria Rahmi ◽  
Priscila de Oliveira ◽  
Luciano Selistre ◽  
Paulo Cury Rezende ◽  
Gabriela Neuvald Pezzella ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
Continuous Glucose Monitoring ◽  
Glucose Tolerance Test ◽  
Glucose Monitoring ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels

Objective The objective of the present study was to compare 24-hour glycemic levels between obese pregnant women with normal glucose tolerance and non-obese pregnant women. Methods In the present observational, longitudinal study, continuous glucose monitoring was performed in obese pregnant women with normal oral glucose tolerance test with 75 g of glucose between the 24th and the 28th gestational weeks. The control group (CG) consisted of pregnant women with normal weight who were selected by matching the maternal age and parity with the same characteristics of the obese group (OG). Glucose measurements were obtained during 72 hours. Results Both the groups were balanced in terms of baseline characteristics (age: 33.5 [28.7–36.0] vs. 32.0 [26.0–34.5] years, p = 0.5 and length of pregnancy: 25.0 [24.0–25.0] vs. 25.5 [24.0–28.0] weeks, p = 0.6 in the CG and in the OG, respectively). Pre-breakfast glycemic levels were 77.77 ± 10.55 mg/dL in the CG and 82.02 ± 11.06 mg/dL in the OG (p<0.01). Glycemic levels at 2 hours after breakfast were 87.31 ± 13.10 mg/dL in the CG and 93.48 ± 18.74 mg/dL in the OG (p<0.001). Daytime blood glucose levels were 87.6 ± 15.4 vs. 93.1 ± 18.3 mg/dL (p<0.001) and nighttime blood glucose levels were 79.3 ± 15.8 vs. 84.7 ± 16.3 mg/dL (p<0.001) in the CG and in the OG, respectively. The 24-hour, daytime, and nighttime values of the area under the curve were higher in the OG when compared with the CG (85.1 ± 0.16 vs. 87.9 ± 0.12, 65.6 ± 0.14 vs. 67.5 ± 0.10, 19.5 ± 0.07 vs. 20.4 ± 0.05, respectively; p<0.001). Conclusion The results of the present study showed that obesity in pregnancy was associated with higher glycemic levels even in the presence of normal findings on glucose tolerance test.

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