Endocrine Abstracts

Introduction: Gestational diabetes mellitus (GDM) is associated with an increase of maternal-fetal complications. Continuous glucose monitoring system (CGMS) detects postprandial hyperglycemia and hypoglycemia during 24 h.

Methods: Women with GDM in gestational weeks 26–32 were allocated a CGMS (Ipro^TM2) after diagnosis in an observational prospective study. It was analysed:

- CGMS: Mean glucose and standard deviation, area under the curve (AUC) with glucose >140 and <70. Percentage of glucose above or below the limit of normality before and after breakfast, lunch, dinner and night. (Target ranges: before meals 70–95, after meal 70–140 and night 70–120 (expressed: mg/dl)).

- Maternal and neonatal outcomes.

Results: n=32. Maternal age 33 years (>35 years =43.8%), family history of diabetes 47%, personal history of diabetes 34.4%, prepregnancy BMI 25.9 kg/m² (>30 kg/m² =21.8%), weigh gain 7.7 kg, HbA1c 4.9%, insulin treatment 28%. CGMS: Glucose before breakfast 90±7.5, after breakfast 120±20, before lunch 86±9.9, after lunch 112±19.6, before dinner 93±12.3 and after dinner 110±17.8. AUC >140=0.81 and <70=0.59. Percentage of glucose above or below targets: before breakfast >95=33.6% and <70=5.4%, after breakfast >140=24.6% and <70=0.6%, before lunch >95=20.8% and <70=11.9%, after lunch >140=14.5% and <70=2.2%, before dinner >95=37.6% and <70=6.3%, after dinner >140=8.1% and <70=2.9%, night >120=8.4% and <70=8.9%. Maternal and neonatal outcomes: Caesarean 25%, gestational age at delivery 39 week, macrosomia 12.5%, large for gestational age 25%, small for gestational age 6.3%, neonatal hypoglycaemia 21.9%, need for supplemental oxygen in the neonatal 6.3%.

Conclusions: SMCG showed preprandial hyperglycemia, mainly before breakfast and dinner. Few hypoglycemias were detected but before lunch and night. Maternal and neonatal outcomes were similar to other studies.