Endocrine Abstracts

Introduction: Glycemic variability (GV) is a more accurate parameter for assessing the risk of developing diabetic complications than traditional parameters for assessing compensation. In most cases, diet therapy is used to treat GDM, while the glycemia in a pregnant woman should correspond to the glucose level in healthy pregnant women. The aim of our work is to compare two-week glycemic profiles and GV in pregnant women with GDM on diet therapy and in healthy pregnant women using the FreeStyle Libre flash monitor system.

Materials and methods: Analysis of the glycemic profile of 62 pregnant women aged 33.2±6.1 years. The average gestational age of the women included in the study was 12.6±6.4 weeks of gestation. The pregnant women were divided into 2 groups: 50 pregnant women with GDM and 12 healthy pregnant women. According to the self-monitoring diary using a glucometer, all pregnant women with GDM had target glycemic values. Each group underwent a two-week glucose profile monitoring using the FreeStyle Libre continuous monitoring system. To assess GV, the following parameters were used, reflecting various characteristics of the glycemic curve: SD characterizes the degree of scatter in glycemic values; MAGE is the average amplitude of glycemic fluctuations; MAG - reflects the rate of change in glucose levels; CONGA - duration of glycemic increase; HBGI – hyperglycemia risk index; LBGI – hypoglycemia risk index; ADDR is the average value of risks.

Results: Taking into account the peculiarities of control in GDM, the threshold values of the normal range were changed in accordance with the target values for pregnant women with GDM. Indicators of glycemia and glycemic variability were significantly higher in the group of pregnant women with GDM compared with pregnant women without carbohydrate metabolism disorders, but within the target range. The average level of glycemia in the groups was 4.724±0.37 mmol/l vs 4.24±0.34 mmol/l, respectively (P<0.0001). Comparative analysis of GV parameters in groups: SD - 0.8 vs 0.7213 (P<0.05); LI- 1.4 vs 0.8 (P<0.05); LBGI 5.56 vs 4.6 (P<0.05); HBGI- 0.43 vs 0.42 (P=0.06); J-index- 9.98 vs 7.9870 (P<0.001); MOOD- 0.96 vs 0.79 (P=0.07); MAGE- 2.3 vs 1.8 (P<0.05); ADDR- 1.02 vs 0.4210 (P<0.05); MAG- 3.8 vs 2.6 (P<0.001), CONGA index 3.9 vs 3.7 (P=0.09), respectively.

Conclusions: Flash glycemic monitoring can be used to obtain more detailed information about the glycemic profile, especially when it is difficult to assess the degree of GDM compensation.