仅仅佩戴动态血糖检测仪,不足以改变妊娠糖尿病结局
  • 糖尿病与不良妊娠结局高风险相关。
  • 将1型和2型糖尿病于妊娠<16周采用胰岛素治疗者、妊娠糖尿病于妊娠<30周采用胰岛素治疗患者,随机分配(1:1分配)为两组。
  • 分别采用间歇式回顾性CGM(每6周进行动态血糖监测5-7天)和标准常规检测(自我监测血糖和HbA1c)。
  • 两组巨大儿发生率分别为31.0%和28.4%,HbA1c水平无明显差异。
  • 作为糖尿病治疗的策略之一,动态血糖监测虽然可以更详细显示血糖波动的信息,但是没有改善妊娠结局。
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Diabetes [IF:7.199]

Continuous Glucose Monitoring during Diabetic Pregnancy (GlucoMOMS); a multicentre randomised controlled trial

糖尿病患者妊娠期间动态血糖监测(CGM):多中心随机对照研究

10.1111/dom.13310

2018-03-30, Article

Abstract & Authors:展开

Abstract:收起
Diabetes is associated with a high risk of adverse pregnancy outcomes. Optimal glycaemic control is fundamental and is traditionally monitored with self-measured glucose profiles and periodic HbA1c measurements. We investigated the effectiveness of additional use of retrospective continuous glucose monitoring (CGM) in diabetic pregnancies.We performed a nationwide multicentre, open label, randomized, controlled trial to study pregnant women with type 1 or type 2 diabetes who were undergoing insulin therapy at gestational age < 16 weeks, or women who were undergoing insulin treatment for gestational diabetes at gestational age < 30 weeks. Women were randomly allocated (1:1) to intermittent use of retrospective CGM or to standard treatment. Glycaemic control was assessed by CGM for 5-7 days every 6 weeks in the CGM group, while self-monitoring of blood glucose and HbA1c measurements were applied in both groups. Primary outcome was macrosomia, defined as birth weight above the 90th percentile. Secondary outcomes were glycaemic control and maternal and neonatal complications.Between July 2011 and September 2015, we randomized 300 pregnant women with type 1 (n = 109), type 2 (n = 82) or with gestational (n = 109) diabetes to either CGM (n = 147) or standard treatment (n = 153). The incidence of macrosomia was 31.0% in the CGM group and 28.4% in the standard treatment group (relative risk [RR], 1.06; 95% CI, 0.83-1.37). HbA1c levels were similar between treatment groups.In diabetic pregnancy, use of intermittent retrospective CGM did not reduce the risk of macrosomia. CGM provides detailed information concerning glycaemic fluctuations but, as a treatment strategy, does not translate into improved pregnancy outcome.

First Authors:
Daphne N Voormolen

Correspondence Authors:
Daphne N Voormolen

All Authors:
Daphne N Voormolen,J Hans DeVries,Rieneke M E Sanson,Martijn P Heringa,Harold W de Valk,Marjolein Kok,Aren J van Loon,Klaas Hoogenberg,Dick J Bekedam,Teri C B Brouwer,Martina Porath,Ronald J Erdtsieck,Bas NijBijvank,Huib Kip,Olivier W H van der Heijden,Lammy D Elving,Brenda B Hermsen,B J Potter van Loon,Robert J P Rijnders,Henry J Jansen,Josje Langenveld,Bettina M C Akerboom,Rosalie M Kiewiet,Christiana A Naaktgeboren,Ben W J Mol,Arie Franx,Inge M Evers

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