Glucose levels measured with continuous glucose monitoring in uncomplicated pregnancies Journal Article uri icon
Overview
abstract
  • INTRODUCTION: To characterize glucose levels during uncomplicated pregnancies, defined as pregnancy with a hemoglobin A1c <5.7% (<39鈥塵mol/mol) in early pregnancy, and without a large-for-gestational-age birth, hypertensive disorders of pregnancy, or gestational diabetes mellitus (ie, abnormal oral glucose tolerance test). RESEARCH DESIGN AND METHODS: Two sites enrolled 937 pregnant individuals aged 18 years and older prior to reaching 17 gestational weeks; 413 had an uncomplicated pregnancy (mean卤SD鈥塨ody mass index (BMI) of 25.3卤5.0鈥塳g/m(2)) and wore Dexcom G6 continuous glucose monitoring (CGM) devices throughout the observed gestational period. Mealtimes were voluntarily recorded. Glycemic levels during gestation were characterized using CGM-measured glycemic metrics. RESULTS: Participants wore CGM for a median of 123 days each. Glucose levels were nearly stable throughout all three trimesters in uncomplicated pregnancies. Overall mean卤SD glucose during gestation was 98卤7鈥塵g/dL (5.4卤0.4鈥塵mol/L), median per cent time 63-120鈥塵g/dL (3.5-6.7鈥塵mol/L) was 86% (IQR: 82-89%), median per cent time <63鈥塵g/dL (3.5鈥塵mol/L) was 1.8%, median per cent time >120鈥塵g/dL (6.7鈥塵mol/L) was 11%, and median per cent time >140鈥塵g/dL (7.8鈥塵mol/L) was 2.5%. Mean post-prandial peak glucose was 126卤22鈥塵g/dL (7.0卤1.2鈥塵mol/L), and mean post-prandial glycemic excursion was 36卤22鈥塵g/dL (2.0卤1.2鈥塵mol/L). Higher mean glucose levels were low to moderately associated with pregnant individuals with higher BMIs (103卤6鈥塵g/dL (5.7卤0.3鈥塵mol/L) for BMI 鈮� 30.0鈥塳g/m(2) vs 96卤7鈥塵g/dL (5.3卤0.4鈥塵mol/L) for BMI 18.5-<25鈥塳g/m(2), r=0.35). CONCLUSIONS: Mean glucose levels and time 63-120鈥塵g/dL (3.5-6.7鈥塵mol/L) remained nearly stable throughout pregnancy and values above 140鈥塵g/dL (7.8鈥塵mol/L) were rare. Mean glucose levels in pregnancy trend higher as BMI increases into the overweight/obesity range. The glycemic metrics reported during uncomplicated pregnancies represent treatment targets for pregnant individuals.

  • Link to Article
  • publication date
  • 2024
  • published in
    Research
    keywords
  • Blood
  • Diabetes
  • Follow-Up Studies
  • Monitoring, Physiologic
  • Pregnancy
  • Additional Document Info
    volume
  • 12
  • issue
  • 3