title: Continuous glucose profiles in obese and normal-weight pregnant women on a controlled diet: metabolic determinants of fetal growth.
abstract: OBJECTIVE
  We sought to define 24-h glycemia in normal-weight and obese pregnant women using continuous glucose monitoring (CGM) while they consumed a habitual and controlled diet both early and late in pregnancy.
  
  
  METHODS
  Glycemia was prospectively measured in early (15.7 ± 2.0 weeks' gestation) and late (27.7 ± 1.7 weeks' gestation) pregnancy in normal-weight (n = 22) and obese (n = 16) pregnant women on an ad libitum and controlled diet. Fasting glucose, triglycerides (early pregnancy only), nonesterified fatty acids (FFAs), and insulin also were measured.
  
  
  RESULTS
  The 24-h glucose area under the curve was higher in obese women than in normal-weight women both early and late in pregnancy despite controlled diets. Nearly all fasting and postprandial glycemic parameters were higher in the obese women later in pregnancy, as were fasting insulin, triglycerides, and FFAs. Infants born to obese mothers had greater adiposity. Maternal BMI (r = 0.54, P = 0.01), late average daytime glucose (r = 0.48, P < 0.05), and late fasting insulin (r = 0.49, P < 0.05) correlated with infant percentage body fat. However, early fasting triglycerides (r = 0.67, P < 0.001) and late fasting FFAs (r = 0.54, P < 0.01) were even stronger correlates.
  
  
  CONCLUSIONS
  This is the first study to demonstrate that obese women without diabetes have higher daytime and nocturnal glucose profiles than normal-weight women despite a controlled diet both early and late in gestation. Body fat in infants, not birth weight, was related to maternal BMI, glucose, insulin, and FFAs, but triglycerides were the strongest predictor. These metabolic findings may explain higher rates of infant macrosomia in obese women, which might be targeted in trials to prevent excess fetal growth.
authors.affiliation: Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Denver, Aurora, Colorado, USA.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Harmon
authors.forename: Lori
authors.initials: L
authors.lastname: Gerard
authors.forename: Dalan R
authors.initials: DR
authors.lastname: Jensen
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Kealey
authors.forename: Teri L
authors.initials: TL
authors.lastname: Hernandez
authors.forename: Melanie S
authors.initials: MS
authors.lastname: Reece
authors.forename: Linda A
authors.initials: LA
authors.lastname: Barbour
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Bessesen
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight / Q000502:physiology; D004032:Diet; D005215:Fasting / Q000097:blood; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood; D008297:Male; D009765:Obesity / Q000097:blood* / Q000178:diet therapy*; D011247:Pregnancy; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D014280:Triglycerides