title: Concealed maternal blood glucose excursions correlate with birth weight centile.
abstract: BACKGROUND
  The objective of this study was to test the hypothesis that maternal blood glucose excursions correlate with deviation from optimized birth weight.
  
  
  METHODS
  Patients were recruited for 3-day continuous glucose monitoring (CGM) plus self-blood glucose monitoring followed by routine diabetes screening at 26-28 weeks gestation. Patients and caregivers were blinded to CGM results. The magnitude and duration of blood glucose (BG) excursions were measured as a "glycemia index." A customized birth weight centile was calculated.
  
  
  RESULTS
  Twenty-three patients consented, 21 completed the study: 5 diabetic and 16 nondiabetic individuals. The duration of CGM was 72 (+/-7.2) hours, and each patient performed self-BG monitoring >/=3 times per day. All diabetic and 10 nondiabetic patients had several measured BG excursions above 130 mg/dl. A positive correlation was observed between birth weight centile and glycemia index above 130 (p < 0.03); the trend persisted for nondiabetic patients alone (p < 0.05). No significant correlation was noted between birth weight centile and average 3-day CGM values, 3-day fasting BG, average 3-day self-BG monitoring values, or diabetes screening BG value.
  
  
  CONCLUSIONS
  The glycemia index has a better correlation with birth weight centile than BG measured by conventional methods in a mixed diabetic and nondiabetic population. Fetal exposure to maternal blood glucose excursions correlates positively with fetal growth, even in nondiabetic patients with apparently normal glucose tolerance.
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University, Stanford, California 94305-5317, USA. mtaslimi@stanford.edu
authors.forename: Masoud Mark
authors.initials: MM
authors.lastname: Taslimi
authors.forename: Kasra
authors.initials: K
authors.lastname: Navabi
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Acosta
authors.forename: Amy
authors.initials: A
authors.lastname: Helmer
authors.forename: Yasser Y
authors.initials: YY
authors.lastname: El-Sayed