title: Poor glucose control in women with type 1 diabetes mellitus and 'safe' hemoglobin A1c values in the first trimester of pregnancy.
abstract: OBJECTIVE
  To observe glycemic excursions, measured continuously over 24 h, in relation to hemoglobin A1c values in the first trimester of pregnancy of women with type 1 diabetes mellitus.
  
  
  METHODS
  The MiniMed Continuous Glucose Monitoring System (CGMS) was used to obtain glucose values every 5 min during 24 h. Hemoglobin A1c was determined at the end of the continuous glucose recording and 6-12 weeks after the continuous glucose recording.
  
  
  RESULTS
  Continuous glucose recordings were obtained in 13 women between 7 and 15 weeks of gestation. Nine patients had hemoglobin A1c levels of < or = 7.0% (< 1% above the upper limit of normal range) while up to 41.3% of the readings had values of < 3.9 mmol/l (70 mg/dl) and up to 52.8% of the readings had values of > 7.8 mmol/l (140 mg/dl).
  
  
  CONCLUSIONS
  Hemoglobin A1c does not reflect the complexities of glycemic control in women with type 1 diabetes who are considered to have accomplished tight glycemic control in the first trimester of pregnancy.
authors.affiliation: Department of Obstetrics, University Medical Centre Utrecht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Kerssen
authors.forename: I M
authors.initials: IM
authors.lastname: Evers
authors.forename: H W
authors.initials: HW
authors.lastname: de Valk
authors.forename: G H A
authors.initials: GH
authors.lastname: Visser
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D006441:Hemoglobin A / Q000378:metabolism*; D006801:Humans; D018670:Monitoring, Ambulatory; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011254:Pregnancy in Diabetics / Q000097:blood*
chemical_list: D001786:Blood Glucose; D006441:Hemoglobin A