title: Glucose variability in diabetic pregnancy.
abstract: BACKGROUND
  Fetal overgrowth is the most important complication of gestational (GDM) and pregestational diabetes mellitus.
  
  
  METHODS
  We correlated maternal glucose profiles, as detected by continuous glucose monitoring (CGM), with fetal growth parameters for 80 pregnant women (32 with type 1 diabetes, 31 with GDM, and 17 healthy controls). Glucose profiles were monitored in the first, second, and third trimesters of pregnancy for type 1 diabetes women and in the second and third trimesters for GDM women and controls. To analyze glycemic variability, we considered the mean amplitude of glycemic excursion, mean glycemia, the continuous overlapping net glycemic action (CONGA), the SD, the High Blood Glucose Index (HBGI), the Low Blood Glucose Index, and the interquartile range (IQR).
  
  
  RESULTS
  Mean age was the same for the three groups. Prepregnancy body mass index was higher for the women with diabetes (GDM and type 1) than for controls. The newborn's mean birth weight and ponderal index were higher, although not significantly so, for the women with diabetes than for controls. For the type 1 diabetes patients, ponderal index correlated with the HBGI in the first trimester, CONGA1 and IQR in the second, and mean glycemia and SD in the third. For GDM patients, ponderal index correlated with mean glycemia and the HBGI in the second trimester.
  
  
  CONCLUSIONS
  Fetal exposure to glycemic variability and hyperglycemia seems to be important in determining fetal overgrowth in pregnant women with diabetes. Optimal glucose control and less glucose variability are needed as early as possible in both type 1 diabetes and GDM patients to ensure normal fetal growth.
authors.affiliation: Department of Medical and Surgical Sciences, University of Padua, Padua, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Dalfrà
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sartore
authors.forename: Graziano
authors.initials: G
authors.lastname: Di Cianni
authors.forename: Giorgio
authors.initials: G
authors.lastname: Mello
authors.forename: Cristina
authors.initials: C
authors.lastname: Lencioni
authors.forename: Serena
authors.initials: S
authors.lastname: Ottanelli
authors.forename: Jolanda
authors.initials: J
authors.lastname: Sposato
authors.forename: Francesco
authors.initials: F
authors.lastname: Valgimigli
authors.forename: Cosimo
authors.initials: C
authors.lastname: Scuffi
authors.forename: Marco
authors.initials: M
authors.lastname: Scalese
authors.forename: Annunziata
authors.initials: A
authors.lastname: Lapolla
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*
chemical_list: D001786:Blood Glucose