Abstract

Background: Fetal overgrowth is the most important complication of gestational (GDM) and pregestational diabetes mellitus.
Methods: We correlated maternal glucose profiles, as detected by continuous glucose monitoring (CGM), with fetal growth parameters for 80 pregnant women (32 with type 1 diabetes, 31 with GDM, and 17 healthy controls). Glucose profiles were monitored in the first, second, and third trimesters of pregnancy for type 1 diabetes women and in the second and third trimesters for GDM women and controls. To analyze glycemic variability, we considered the mean amplitude of glycemic excursion, mean glycemia, the continuous overlapping net glycemic action (CONGA), the SD, the High Blood Glucose Index (HBGI), the Low Blood Glucose Index, and the interquartile range (IQR).
Results: Mean age was the same for the three groups. Prepregnancy body mass index was higher for the women with diabetes (GDM and type 1) than for controls. The newborn's mean birth weight and ponderal index were higher, although not significantly so, for the women with diabetes than for controls. For the type 1 diabetes patients, ponderal index correlated with the HBGI in the first trimester, CONGA1 and IQR in the second, and mean glycemia and SD in the third. For GDM patients, ponderal index correlated with mean glycemia and the HBGI in the second trimester.
Conclusions: Fetal exposure to glycemic variability and hyperglycemia seems to be important in determining fetal overgrowth in pregnant women with diabetes. Optimal glucose control and less glucose variability are needed as early as possible in both type 1 diabetes and GDM patients to ensure normal fetal growth.

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cover image Diabetes Technology & Therapeutics
Diabetes Technology & Therapeutics
Volume 13Issue Number 8August 2011
Pages: 853 - 859
PubMed: 21751862

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Published in print: August 2011
Published online: 13 July 2011

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Maria Grazia Dalfrà
Department of Medical and Surgical Sciences, University of Padua, Padua, Italy.
Giovanni Sartore
Department of Medical and Surgical Sciences, University of Padua, Padua, Italy.
Graziano Di Cianni
Department of Endocrinology and Metabolic Diseases, University of Pisa, Pisa, Italy.
Giorgio Mello
Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy.
Cristina Lencioni
Department of Endocrinology and Metabolic Diseases, University of Pisa, Pisa, Italy.
Serena Ottanelli
Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy.
Jolanda Sposato
A. Menarini Diagnostics, Florence, Italy.
Francesco Valgimigli
A. Menarini Diagnostics, Florence, Italy.
Cosimo Scuffi
A. Menarini Diagnostics, Florence, Italy.
Marco Scalese
CNR, Institute of Clinical Physiology, Pisa, Italy.
Annunziata Lapolla
Department of Medical and Surgical Sciences, University of Padua, Padua, Italy.

Notes

Address correspondence to:Annunziata Lapolla, M.D.Department of Medical and Surgical SciencesUniversity of PaduaVia Giustiniani n 235128 Padova, Italy
E-mail: [email protected]

Author Disclosure Statement

J.S., F.V., and C.S. are employees of A. Menarini Diagnostics. No competing financial interests exist for M.G.D., G.S., G.D.C., G.M., C.L., S.O., M.S., and A.L.

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