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International Journal of Endocrinology
Volume 2013, Article ID 279021, 8 pages
http://dx.doi.org/10.1155/2013/279021
Clinical Study

Glucose Fluctuations during Gestation: An Additional Tool for Monitoring Pregnancy Complicated by Diabetes

1Department of Medicine, Unit of Metabolic Diseases, University of Padua, Via Giustiniani no. 2, 35128 Padua, Italy
2Department of Endocrinology & Metabolism, Section of Metabolic Diseases & Diabetes, AOUP Pisa, University of Pisa, Ospedale Cisanello, Via Paradisa no. 2, 56124 Pisa, Italy
3Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Viale Giovan Battista Morgagni no. 85, 50134 Florence, Italy
4CNR, Institute of Clinical Physiology, Via G. Moruzzi no. 1, 56124 Pisa, Italy

Received 20 May 2013; Revised 19 September 2013; Accepted 30 September 2013

Academic Editor: Stuart Tobet

Copyright © 2013 M. G. Dalfrà et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Continuous glucose monitoring (CGM) gives a unique insight into magnitude and duration of daily glucose fluctuations. Limited data are available on glucose variability (GV) in pregnancy. We aimed to assess GV in healthy pregnant women and cases of type 1 diabetes mellitus or gestational diabetes (GDM) and its possible association with HbA1c. CGM was performed in 50 pregnant women (20 type 1, 20 GDM, and 10 healthy controls) in all three trimesters of pregnancy. We calculated mean amplitude of glycemic excursions (MAGE), standard deviation (SD), interquartile range (IQR), and continuous overlapping net glycemic action (CONGA), as parameters of GV. The high blood glycemic index (HBGI) and low blood glycemic index (LBGI) were also measured as indicators of hyperhypoglycemic risk. Women with type 1 diabetes showed higher GV, with a 2-fold higher risk of hyperglycemic spikes during the day, than healthy pregnant women or GDM ones. GDM women had only slightly higher GV parameters than healthy controls. HbA1c did not correlate with GV indicators in type 1 diabetes or GDM pregnancies. We provided new evidence of the importance of certain GV indicators in pregnant women with GDM or type 1 diabetes and recommended the use of CGM specifically in these populations.