Changes in the Glycemic Profiles of Women With Type 1 and Type 2 Diabetes During Pregnancy

作者：Helen Murphy, Gerry A. Rayman, Katherine Duffield, Karen Lewis, Susan Kelly, Balroop Johal, Duncan Fowler, Rosemary Temple · 发表于：Diabetes Care · 年份：2007 · DOI：10.2337/dc07-0500 · 被引用次数：139 · 研究领域：Gestational Diabetes Research and Management、Diabetes Management and Research、Diabetes and associated disorders

OBJECTIVE: To examine the changes in glycemic excursions that occur during pregnancy using continuous glucose monitoring and to compare patterns of glycemia in pregnant women with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS: An observational data analysis was performed from a prospective randomized study of continuous glucose monitoring in 57 women with pregestational type 1 (n = 40) or type 2 (n = 17) diabetes with 7-day continuous glucose monitoring system profiles during each trimester. Serial glucose measurements were divided into periods of euglycemia (70-140 mg/dl), hyperglycemia (>140 mg/dl), and hypoglycemia (<70 mg/dl). Generalized linear mixed effects models were fitted to the repeated measures data to determine how these glycemic characteristics varied during gestation and by diabetes type. RESULTS: A total of 180 continuous glucose profiles were examined (140 type 1 diabetes, 40 type 2 diabetes), providing 20,433 h of data for analysis (16,117 h type 1 diabetes, 4,316 type 2 diabetes). Women with type 2 diabetes spend approximately 33% less time hyperglycemic throughout pregnancy than women with type 1 diabetes (P = 0.005), with a significantly more rapid reduction in time spent hyperglycemic in early pregnancy (P = 0.02). Although women with type 2 diabetes spend less overall time hypoglycemic (P = 0.04), their risk of nocturnal hypoglycemia is equivalent to that of women with type 1 diabetes (blood glucose level <70 mg/dl, P = 0.9; blood glucose leve...