Assessment of glycemic variability using the FreeStyle Libre flash monitoring system in pregnant women with gestational diabetes mellitus

Fatima Ushanova; Tatyana Demidova; Mariyam Izmailova

doi:10.1530/endoabs.73.AEP610

Background and aim

Early control of gestational diabetes mellitus (GDM) can reduce the likelihood of adverse maternal and fetal outcomes. Glycemic variability (GV) is a more accurate parameter for assessing the risk of developing diabetic complications than traditional parameters of assessing compensation. In most cases, diet therapy is used to treat GDM, meanwhile the glycemia in pregnant women with GDM should correspond to the glucose level in healthy pregnant women. The aim of our work was to compare biweekly glycemic profiles and glucose variability in healthy pregnant women and pregnant women with GDM on diet therapy using the FreeStyle Libre flash monitor system.

Materials and methods

Analysis of the glycemic profile of 40 pregnant women aged 25.47 ± 5.83 using the FreeStyle Libre continuous monitoring system. Pregnant women were divided into 2 groups: 20 healthy pregnant women and 20 pregnant women with GDM on diet therapy. Each group was evaluated for ambulatory glucose profile monitoring over a two week period using the FreeStyle Libre system.

Results

Age and HbA1c levels were comparable in both groups, but body mass index (BMI) before pregnancy was higher in the GDM group (P = 0.026). Women with GDM had higher blood glucose levels than healthy pregnant women, but within the target range. In patients with GDM, who were compensated for carbohydrate metabolism during diet therapy, there was a low variability of glycemia according to standard indices. There were significant differences in mean glycemia and J-index, which characterizes the maximum peak of glycemia (Table 1).


Measures of Glucose Variability	Patient group		n	p
Measures of Glucose Variability	GDM	Healthy pregnant women	n	p
SD, mmol\l	0.911	0.884	0–3.0	0.61
CONGA	3.980	3.875	3.6–5.5	0.27
LI	1.450	1.256	0–4.7	0.28
J-index	10.291	9.564	4.7–23.6	<0.05
HBGI	0.647	0.762	0–7.7	0.54
LBGI	4.728	5.665	0–4.6	0.16
MOOD	0.963	0.935	0–3.5	0.64
MAGE	2.31	2.263	0–2.8	0.72
ADDR	3.007	1.935	0–8.7	0.27
M-value	7.677	10.088		0.14
Mean glucose	3.6	3.1		<0.02

Findings

In order to obtain more detailed information about the glycemic profile, especially when it is difficult to assess the degree of compensation for GDM, modern devices for Flash glycemic monitoring can be of great value. Continuous monitoring allows a more thorough assessment of the effects of GDM therapy, at the same time, further researches are required to assess the significance of these data.

Endocrine Abstracts

AEP610