• J. Clin. Endocrinol. Metab. · Dec 2014

    Continuous glucose monitoring effects on maternal glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus: a prospective cohort study.

    • Fan Yu, Lijuan Lv, Zhijiang Liang, Yi Wang, Jiying Wen, Xiaohong Lin, Yuheng Zhou, Caiyuan Mai, and Jianmin Niu.
    • Department of Obstetrics and Gynecology (F.Y., L.L., Y.W., J.Wen, X.L., Y.Z., C.M., J.N.) and Healthcare Department (Z.L.), GuangDong Women and Children Hospital, Guangzhou, China 510010.
    • J. Clin. Endocrinol. Metab. 2014 Dec 1; 99 (12): 4674-82.

    ContextClinical evidence on the consequential effects of continuous glucose monitoring (CGM) on pregnancy outcomes in women with gestational diabetes mellitus (GDM) is scarcely available.ObjectiveOur objective was to evaluate the effectiveness of CGM on maternal glycemic control and pregnancy outcomes in patients with GDM .PatientsIn total, 340 Chinese pregnant women with GDM were allocated to either the routine care group (n = 190) or the CGM group (n =150).Design And SettingThis was a prospective cohort study in the Department of Obstetrics of GuangDong Women and Children Hospital in China. Recruitment started in April 2011 and stopped in August 2012.InterventionsA 72-hour CGM system was used as a supplementary tool for glucose monitoring in the CGM group. PRIMARY OUTCOME MEASUREMENTS: The parameters of glycemic variability included mean blood glucose, the SD of blood glucose, mean amplitude of glycemic excursions (MAGEs), and the mean of daily differences. The maternal outcomes (preeclampsia and cesarean delivery) and composite neonatal outcomes were analyzed.ResultsThe SD of blood glucose, MAGEs, and mean of daily differences values were significantly lower in the CGM group compared with those of the routine care group (P < .001). Subjects in the CGM group were at lower risk of preeclampsia and primary cesarean delivery compared with the routine care group (P < .05). The mean infant birth weight of women in the CGM group was lower than infants of women in the routine care group (P < .001). The MAGE was associated with birth weight (β = 0.196, P < .001), and it was an independent factor for preeclampsia (odds ratio, 3.66; 95% confidence interval 2.16-6.20) and composite neonatal outcome (odds ratio, 1.34; 95% confidence interval 1.01-1.77).ConclusionsThe use of supplementary CGM combined with routine antenatal care can improve the glycemic control and pregnancy outcomes of patients with GDM.

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