HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) All Versions of this Article: dc07-0500v1 30/11/2785    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Murphy, H. Articles by Temple, R. Search for Related Content PubMed PubMed Citation Articles by Murphy, H. Articles by Temple, R. Social Bookmarking                What's this?

Changes in the glycaemic profiles of women with type 1 and type 2 diabetes during pregnancy

¹ Diabetes and Obstetrics, Ipswich Hospital NHS Trust, Ipswich, United Kingdom
² Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, Norwich, United Kingdom

Helen.Murphy{at}ipswichhospital.nhs.uk

ABSTRACT

Aims –: To examine the changes in glycaemic excursions which occur during pregnancy using continuous glucose monitoring and to compare patterns of glycaemia in pregnant women with type 1 and type 2 diabetes.

Research design and methods –: Observational data analysis from a prospective randomised study of continuous glucose monitoring in 57 women with pregestational type 1 (n=40) or type 2 diabetes (n=17) with 7-day CGMS profiles during each trimester. Serial glucose measurements were divided into periods of euglycaemia (70-140mg/dl), hyperglycaemia (>140mg/dl) and hypoglycaemia (< 70mg/dl). Generalised linear mixed effects models were fitted to the repeated measures data to determine how these glycaemic characteristics varied during gestation and by diabetes type.

Results –: 180 continuous glucose profiles were examined (140 type 1 diabetes, 40 type 2 diabetes) providing 20,433 hours of data for analysis (16,117 hours type 1 diabetes, 4,316 type 2 diabetes). Women with type 2 diabetes spend 33% less time hyperglycaemic throughout pregnancy compared to women with type 1 diabetes (p=0.005), with a significantly more rapid reduction in time spent hyperglycaemic in early pregnancy (p=0.02). Although women with type 2 diabetes spend less overall time hypoglycaemic (p=0.04), their risk of nocturnal hypoglycaemia is equivalent to women with type 1diabetes (BGL<70mg/dl, p = 0.9; BGL<50mg/dl, p = 0.2).

Conclusions –: Continuous glucose monitoring reveals clear differences in the level of glycaemic control that exist in women with type 1 and type 2 diabetes. These data will guide therapeutic interventions aimed at optimising glycaemic control and improving the pregnancy outcomes of both type 1 and type 2 diabetes.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?