Endocrine Abstracts

Introduction: Gestational diabetes mellitus (GDM) is associated with an increase of maternal-fetal complications. Continuous glucose monitoring system (CGMS) detects parameters of glycemic variability through which it could be predicted the appearance of maternal-fetal complications.

Methods: Women with GDM at 26–32 gestational weeks were allocated a 6-day CGM system (Ipro^TM2) right after diagnosis in an observational prospective study. It was analysed:

CGMS: mean glucose and standard deviation (S.D.), mean amplitude of glycemic excursions (MAGE), mean of daily differences (MOOD), continuous overlapping net glycemic action (CONGA). Expressed: mg/dl.: Maternal and neonatal outcomes.

Results: n=52. Maternal age 30±2.42 years (>35 years=40.3%), family history of diabetes 57.7%, prepregnancy BMI 26.1±4.62 kg/m² (>30 kg/m²=23.1%), weigh gain 7.6±5.19 kg, HbA1c 4.9%, insulin treatment 32.7%.

CGMS: mean 98.02, DS 19.66, MAGE 44.22±13.16, MODD 19.44±5.74, CONGA 86.19±8.56.

Maternal and neonatal outcomes: Caesarean 32.7%, gestational age at delivery 39 week, macrosomia 9.6%, large for gestational age (LGA) 21.2%, small for gestational age 5.8%, neonatal hypoglycaemia 25%, neonatal hyperbilirubinemia 7.7% and need for supplemental oxygen in the neonatal 5.8%.

Multivariable binary logistic regression: MAGE was an independent factor for LGA (Odds ratio 1.075; 95% confidence interval 1.007–1.148; P value 0.031). It was not found another independent risk factor for maternal or neonatal outcomes.

Conclusions: There is a correlation between MAGE at diagnosis of GDM and LGA. The use of CGMS could identify patients with more risk of maternal-fetal complications. These patients should have a close surveillance in order to prevent complications. However, further studies with a larger number of patients are required.