Addition of intermittently scanned continuous glucose monitoring to standard care in a cohort of pregnant women with type 1 diabetes: effect on glycaemic control and pregnancy outcomes.

Blood Glucose Blood Glucose Self-Monitoring / methods Cesarean Section Cohort Studies Diabetes Mellitus, Type 1 / blood Female Fetal Macrosomia / epidemiology Glycated Hemoglobin / analysis Glycemic Control Humans Hypoglycemia / epidemiology Infant, Newborn Pregnancy Pregnancy Outcome Pregnancy in Diabetics / blood Weight Gain
HbA1c Intermittently scanned continuous glucose monitoring Large-for-gestational-age Neonatal hypoglycaemia Pregnancy Type 1 diabetes

Journal

Diabetologia
ISSN: 1432-0428
Titre abrégé: Diabetologia
Pays: Germany
ID NLM: 0006777

Informations de publication

Date de publication:
08 2022
Historique:
received: 11 01 2022
accepted: 30 03 2022
pubmed: 14 5 2022
medline: 19 7 2022
entrez: 13 5 2022
Statut: ppublish

Résumé

The aim of this study was to assess whether the addition of intermittently scanned continuous glucose monitoring (isCGM) to standard care (self-monitoring of blood glucose [SMBG] alone) improves glycaemic control and pregnancy outcomes in women with type 1 diabetes and multiple daily injections. This was a multicentre observational cohort study of 300 pregnant women with type 1 diabetes in Spain, including 168 women using SMBG (standard care) and 132 women using isCGM in addition to standard care. In addition to HbA The isCGM group had a lower median HbA isCGM use provided an initial improvement in glycaemic control that was not sustained. Furthermore, offspring of isCGM users were more likely to have neonatal hypoglycaemia, with similar rates of macrosomia and prematurity to those of women receiving standard care.

Identifiants

DOI: 10.1007/s00125-022-05717-2 PMID: 35546211
pubmed: 35546211
doi: 10.1007/s00125-022-05717-2
pii: 10.1007/s00125-022-05717-2
doi:

Substances chimiques

Blood Glucose 0
Glycated Hemoglobin A 0

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1302-1314

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

Murphy HR, Bell R, Cartwright C et al (2017) Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study. Diabetologia 60(9):1668–1677. https://doi.org/10.1007/s00125-017-4314-3
doi: 10.1007/s00125-017-4314-3 pubmed: 28597075 pmcid: 5552835
Persson M, Norman M, Hanson U (2009) Obstetric and perinatal outcomes in type 1 diabetic pregnancies: a large, population-based study. Diabetes Care 32(11):2005–2009. https://doi.org/10.2337/dc09-0656
doi: 10.2337/dc09-0656 pubmed: 19675195 pmcid: 2768194
Bolinder J, Antuna R, Geelhoed-Duijvestijn P, Kröger J, Weitgasser R (2016) Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial. Lancet 388(10057):2254–2263. https://doi.org/10.1016/S0140-6736(16)31535-5
doi: 10.1016/S0140-6736(16)31535-5 pubmed: 27634581
Beck RW, Riddlesworth T, Ruedy K et al (2017) Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections the diamond randomized clinical trial. JAMA J Am Med Assoc 317(4):371–378. https://doi.org/10.1001/jama.2016.19975
doi: 10.1001/jama.2016.19975
American Diabetes Association (2021) 14. Management of diabetes in pregnancy: standards of medical care in diabetes—2021. Diabetes Care 44(Supplement 1):S200–S210. https://doi.org/10.2337/DC21-S014
doi: 10.2337/DC21-S014
NICE (2020) Diabetes in pregnancy: management from preconception to the postnatal period. Overview. Available from www.nice.org.uk/guidance/ng3 . Accessed 30 Nov 2021
Feig DS, Donovan LE, Corcoy R et al (2017) Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet 390(10110):2347–2359. https://doi.org/10.1016/S0140-6736(17)32400-5
doi: 10.1016/S0140-6736(17)32400-5 pubmed: 28923465 pmcid: 5713979
Secher AL, Ringholm L, Andersen HU, Damm P, Mathiesen ER (2013) The effect of real-time continuous glucose monitoring in pregnant women with diabetes a randomized controlled trial. Diabetes Care 36(7):1877–1883. https://doi.org/10.2337/dc12-2360
doi: 10.2337/dc12-2360 pubmed: 23349548 pmcid: 3687305
Murphy HR, Rayman G, Lewis K et al (2008) Effectiveness of continuous glucose monitoring in pregnant women with diabetes: randomised clinical trial. BMJ 337(7675):907–910. https://doi.org/10.1136/bmj.a1680
doi: 10.1136/bmj.a1680
Voormolen DN, DeVries JH, Sanson RME et al (2018) Continuous glucose monitoring during diabetic pregnancy (GlucoMOMS): a multicentre randomized controlled trial. Diabetes Obes Metab 20(8):1894–1902. https://doi.org/10.1111/dom.13310
doi: 10.1111/dom.13310 pubmed: 29603547
Scott EM, Bilous RW, Kautzky-Willer A (2018) Accuracy, user acceptability, and safety evaluation for the FreeStyle libre flash glucose monitoring system when used by pregnant women with diabetes. Diabetes Technol Ther 20(3):180–188. https://doi.org/10.1089/DIA.2017.0386/ASSET/IMAGES/LARGE/FIGURE2.JPEG
doi: 10.1089/DIA.2017.0386/ASSET/IMAGES/LARGE/FIGURE2.JPEG pubmed: 29470094 pmcid: 5867506
Kristensen K, Ögge LE, Sengpiel V et al (2019) Continuous glucose monitoring in pregnant women with type 1 diabetes: an observational cohort study of 186 pregnancies. Diabetologia 62(7):1143–1153. https://doi.org/10.1007/S00125-019-4850-0
doi: 10.1007/S00125-019-4850-0 pubmed: 30904938 pmcid: 6560021
Tumminia A, Milluzzo A, Festa C et al (2021) Efficacy of flash glucose monitoring in pregnant women with poorly controlled pregestational diabetes (FlashMom): a randomized pilot study. Nutr Metab Cardiovasc Dis 31(6):1851–1859. https://doi.org/10.1016/j.numecd.2021.03.013
doi: 10.1016/j.numecd.2021.03.013 pubmed: 33975741
Acosta D, Balsells M, Ballesteros M et al (2015) Asistencia a la gestante con diabetes. Guía de práctica clínica actualizada en 2014 [article in Spanish]. Avances en Diabetologia 31(2):45–59. https://doi.org/10.1016/j.avdiab.2014.12.001
doi: 10.1016/j.avdiab.2014.12.001
Grupo Español de Diabetes y Embarazo (2021) Diabetes mellitus y embarazo. Guia de práctica clínica actualizada 2021 [article in Spanish]. Prog Obstet Ginecol 2022 65:35–41
Resolución del 26 abril de 2019, de la Dirección General de Cartera Básica de Servicios del Sistema Nacional de Salud y Farmacia del acuerdo de la Comisión de prestaciones, aseguramiento y financiación sobre el sistema de monitorización de glucosa mediante sensores (tipo flash) en adultos [web page in Spanish]. Available from www.sanidad.gob.es/gl/profesionales/prestacionesSanitarias/CarteraDeServicios/ContenidoCS/docs/Resolucionglucosadultos.pdf . Accessed 12 December 2021.
Servicio Canario de Salud (2018) Instrucción n.
Battelino T, Danne T, Bergenstal RM et al (2019) Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care 42(8):1593–1603. https://doi.org/10.2337/DCI19-0028
doi: 10.2337/DCI19-0028 pubmed: 31177185 pmcid: 6973648
Carrascosa Lezcano A, Ferrández Longás A, Yeste Fernández D et al (2008) Estudio transversal español de crecimiento 2008. Parte I: Valores de peso y longitud en recién nacidos de 26-42 semanas de edad gestacional [article in Spanish]. Anales de Pediatria 68(6):544–551. https://doi.org/10.1157/13123286
doi: 10.1157/13123286 pubmed: 18559193
Brown MA, Lindheimer MD, de Swiet M, van Assche A, Moutquin J-M (2001) The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the international society for the study of hypertension in pregnancy (ISSHP). Hypertens Pregnancy 20(1):ix–xiv. https://doi.org/10.1081/PRG-100104165
doi: 10.1081/PRG-100104165 pubmed: 12044323
Metzger BE, Persson B, Lowe LP et al (2010) Hyperglycemia and adverse pregnancy outcome study: neonatal glycemia. Pediatrics 126(6):e1545–e1552. https://doi.org/10.1542/PEDS.2009-2257
doi: 10.1542/PEDS.2009-2257 pubmed: 21078733
European Commission. EUROCAT. Available from https://eu-rd-platform.jrc.ec.europa.eu/eurocat_en . Accessed 30 Nov 2021
Chico A, Herranz L, Corcoy R et al (2016) Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin. Eur J Obstetr Gynecol Reprod Biol 206:84–91. https://doi.org/10.1016/j.ejogrb.2016.07.490
doi: 10.1016/j.ejogrb.2016.07.490
Ananth CV, Schisterman EF (2017) Confounding, causality, and confusion: the role of intermediate variables in interpreting observational studies in obstetrics. Am J Obstetr Gynecol 217(2):167–175. https://doi.org/10.1016/J.AJOG.2017.04.016
doi: 10.1016/J.AJOG.2017.04.016
Yamamoto JM, Corcoy R, Donovan LE et al (2019) Maternal glycaemic control and risk of neonatal hypoglycaemia in type 1 diabetes pregnancy: a secondary analysis of the CONCEPTT trial. Diabet Med 36(8):1046–1053. https://doi.org/10.1111/dme.13988
doi: 10.1111/dme.13988 pubmed: 31107983
Dashora U, Levy N, Dhatariya K, Willer N, Castro E, Murphy HR (2021) Managing hyperglycaemia during antenatal steroid administration, labour and birth in pregnant women with diabetes – an updated guideline from the Joint British Diabetes Society for Inpatient Care. Diabetic Medicine e14744. https://doi.org/10.1111/DME.14744
Sola-Gazagnes A, Faucher P, Jacqueminet S et al (2020) Disagreement between capillary blood glucose and flash glucose monitoring sensor can lead to inadequate treatment adjustments during pregnancy. Diabetes Metab 46(2):158–163. https://doi.org/10.1016/J.DIABET.2019.08.001
doi: 10.1016/J.DIABET.2019.08.001 pubmed: 31415813
Nørgaard SK, Mathiesen ER, Nørgaard K, Ringholm L (2021) Comparison of glycemic metrics measured simultaneously by intermittently scanned continuous glucose monitoring and real-time continuous glucose monitoring in pregnant women with type 1 diabetes. Diabetes Technol Ther 23(10):665–672. https://doi.org/10.1089/DIA.2021.0109
doi: 10.1089/DIA.2021.0109 pubmed: 34086494
Jafri RZ, Balliro CA, El-Khatib F et al (2020) A three-way accuracy comparison of the Dexcom G5, Abbott Freestyle libre pro, and senseonics eversense continuous glucose monitoring devices in a home-use study of subjects with type 1 diabetes. Diabetes Technol Ther 22(11):846–852. https://doi.org/10.1089/DIA.2019.0449
doi: 10.1089/DIA.2019.0449 pubmed: 32453604
García-Patterson A, Gich I, Amini SB, Catalano PM, de Leiva A, Corcoy R (2010) Insulin requirements throughout pregnancy in women with type 1 diabetes mellitus: three changes of direction. Diabetologia 53(3):446–451. https://doi.org/10.1007/s00125-009-1633-z
doi: 10.1007/s00125-009-1633-z pubmed: 20013109
Feig DS, Corcoy R, Donovan LE et al (2018) Pumps or multiple daily injections in pregnancy involving type 1 diabetes: a prespecified analysis of the CONCEPTT randomized trial. Diabetes Care 41(12):2471–2479. https://doi.org/10.2337/dc18-1437
doi: 10.2337/dc18-1437 pubmed: 30327362
Scott EM, Feig DS, Murphy HR, Law GR (2020) Continuous glucose monitoring in pregnancy: importance of analyzing temporal profiles to understand clinical outcomes. Diabetes Care 43(6):1178–1184. https://doi.org/10.2337/DC19-2527
doi: 10.2337/DC19-2527 pubmed: 32209645 pmcid: 7245356
Murphy HR (2019) Continuous glucose monitoring targets in type 1 diabetes pregnancy: every 5% time in range matters. Diabetologia 62(7):1123–1128. https://doi.org/10.1007/S00125-019-4904-3
doi: 10.1007/S00125-019-4904-3 pubmed: 31161344 pmcid: 6560014
Ling P, Yang D, Gu N et al (2021) Achieving the HbA1c target requires longer time in range in pregnant women with type 1 diabetes. J Clin Endocrinol Metab 106(11):e4309–e4317. https://doi.org/10.1210/CLINEM/DGAB502
doi: 10.1210/CLINEM/DGAB502 pubmed: 34244734 pmcid: 8530704
Shah VN, Snell-Bergeon JK, Demmitt J et al (2021) Relationship between time-in-range, HbA1c and the glucose management indicator in pregnancies complicated by type 1 diabetes. Diabetes Technol Ther 23(12):783–790. https://doi.org/10.1089/DIA.2021.0093
doi: 10.1089/DIA.2021.0093 pubmed: 34524020
Sibiak R, Gutaj P, Mrzewka-Rogacz B, Mantaj U, Wender-Ozegowska E (2022) Novel continuous glucose monitoring metrics and LGA risk; an exploratory retrospective cohort study in pregnancies with type 1 diabetes. Diabetes Technol Ther 24(1):42–53. https://doi.org/10.1089/dia.2021.0194
doi: 10.1089/dia.2021.0194 pubmed: 34524000
Law GR, Ellison GTH, Secher AL et al (2015) Analysis of continuous glucose monitoring in pregnant women with diabetes: distinct temporal patterns of glucose associated with large-for-gestational-age infants. Diabetes Care 38(7):1319–1325. https://doi.org/10.2337/dc15-0070
doi: 10.2337/dc15-0070 pubmed: 25906785
Nielsen LR, Ekbom P, Damm P et al (2004) HbA1c levels are significantly lower in early and late pregnancy. Diabetes Care 27(5):1200–1201. https://doi.org/10.2337/diacare.27.5.1200
doi: 10.2337/diacare.27.5.1200 pubmed: 15111545
Gomez-Peralta F, Dunn T, Landuyt K, Xu Y, Merino-Torres JF (2020) Flash glucose monitoring reduces glycemic variability and hypoglycemia: real-world data from Spain. BMJ Open Diabetes Res Care 8(1):e001052. https://doi.org/10.1136/BMJDRC-2019-001052
doi: 10.1136/BMJDRC-2019-001052 pubmed: 32198165 pmcid: 7103828
Meek CL, Tundidor D, Feig DS et al (2021) Novel biochemical markers of glycemia to predict pregnancy outcomes in women with type 1 diabetes. Diabetes Care 44(3):681–689. https://doi.org/10.2337/DC20-2360
doi: 10.2337/DC20-2360 pubmed: 33495292 pmcid: 8051277
Hásková A, Radovnická L, Petruželková L et al (2020) Real-time CGM is superior to flash glucose monitoring for glucose control in type 1 diabetes: the CORRIDA randomized controlled trial. Diabetes Care 43(11):2744–2750. https://doi.org/10.2337/DC20-0112
doi: 10.2337/DC20-0112 pubmed: 32859607 pmcid: 7576432
Nathanson D, Svensson AM, Miftaraj M, Franzén S, Bolinder J, Eeg-Olofsson K (2021) Effect of flash glucose monitoring in adults with type 1 diabetes: a nationwide, longitudinal observational study of 14,372 flash users compared with 7691 glucose sensor naive controls. Diabetologia 64(7):1595–1603. https://doi.org/10.1007/S00125-021-05437-Z/FIGURES/3
doi: 10.1007/S00125-021-05437-Z/FIGURES/3 pubmed: 33774713 pmcid: 8187189

Auteurs

Verónica Perea (V)

Endocrinology Department, Hospital Universitari Mútua de Terrassa, Barcelona, Spain. vperea@mutuaterrassa.cat.
ORCID: 0000-0001-8104-7326

Maria José Picón (MJ)

Endocrinology Department, Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain.
Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
ORCID: 0000-0001-7057-7962

Ana Megia (A)

Endocrinology Department, Hospital Universitari Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain.
Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
ORCID: 0000-0002-5101-9452

Maria Goya (M)

Obstetrics and Gynaecology Department, Hospital Universitari Vall d' Hebrón, Barcelona, Spain.
ORCID: 0000-0003-4001-2017

Ana Maria Wägner (AM)

Endocrinology Department, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain.
Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS), Universidad de las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
ORCID: 0000-0002-7663-9308

Begoña Vega (B)

Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS), Universidad de las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
Obstetrics and Gynaecology Department, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain.
ORCID: 0000-0001-7656-6615

Nuria Seguí (N)

Diabetes Unit, Endocrinology Department, Hospital Clínic de Barcelona, Barcelona, Spain.

Maria Dolores Montañez (MD)

Obstetrics and Gynaecology Department, Hospital 12 de Octubre, Madrid, Spain.

Irene Vinagre (I)

Diabetes Unit, Endocrinology Department, Hospital Clínic de Barcelona, Barcelona, Spain. ivinagre@clinic.cat.
ORCID: 0000-0001-8760-3370

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Classifications MeSH

questionsmedicales.fr › Glucides › Sucres › Oses › Hexose › Glucose › Glycémie › Addition of intermittently scanned continuous...
questionsmedicales.fr › Techniques d'investigation › Techniques de laboratoire clinique › Tests de chimie clinique › Analyse chimique du sang › Autosurveillance glycémique › Addition of intermittently scanned continuous...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie obstétrique › Accouchement (procédure) › Césarienne › Addition of intermittently scanned continuous...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Addition of intermittently scanned continuous...
questionsmedicales.fr › Maladies du système immunitaire › Maladies auto-immunes › Diabète de type 1 › Addition of intermittently scanned continuous...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Macrosomie foetale › Addition of intermittently scanned continuous...
questionsmedicales.fr › Facteurs biologiques › Toxines biologiques › Produits terminaux de glycation avancée › Protéines glyquées › Protéine glycosylée sérique › Hémoglobine glycosylée › Addition of intermittently scanned continuous...
questionsmedicales.fr › Thérapeutique › Régulation de la glycémie › Addition of intermittently scanned continuous...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Addition of intermittently scanned continuous...
questionsmedicales.fr › Maladies métaboliques et nutritionnelles › Maladies métaboliques › Troubles du métabolisme du glucose › Hypoglycémie › Addition of intermittently scanned continuous...
questionsmedicales.fr › Personnes › Tranches d'âge › Nourrisson › Nouveau-né › Addition of intermittently scanned continuous...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Addition of intermittently scanned continuous...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Issue de la grossesse › Addition of intermittently scanned continuous...
questionsmedicales.fr › Maladies urogénitales › Maladies de l'appareil urogénital féminin et complications de la grossesse › Complications de la grossesse › Grossesse chez les diabétiques › Addition of intermittently scanned continuous...
questionsmedicales.fr › Phénomènes physiologiques › Croissance et développement › Croissance › Mensurations corporelles › Poids › Modifications du poids corporel › Prise de poids › Addition of intermittently scanned continuous...