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The best way to monitor blood sugar in pregnant women with type 1 diabetes remains controversial.
, a study published recently in Diabetes Care, an authoritative journal in the field of diabetes, aims to assess the predictive performance of glycified hemoglobin (HbA1c), continuous blood sugar monitoring (CGM) indicators, and alternative blood glucose biocosms in predicting obstetrics and neonatal outcomes.
157 subjects from the CCM Type 1 Diabetes Pregnant Women's Trial (CONCEPTT) were included in this pre-designated secondary analysis.
researchers compared HbA1c, CGM data and alternative biomarkers (glycolytic CD59, 1, 5 dehydrated glucose alcohol, fructamine, glycoglobin) at 12, 24 and 34 weeks of pregnancy using Logistic regression, and predicted pregnancy complications (pre-eclampsia, premature birth, hypernatal age, neonatal hypoglycemia, neonatal hyperglycemia) through the subject's operating characteristics (ROC) curve.
HbA1c, CGM and other laboratory indicators were significantly associated with obstetrics and neonatal outcomes at 24 weeks of pregnancy.
in the early stages of pregnancy, more outcomes were associated with the CCM indicator, and in the late stages of pregnancy, more outcomes were associated with laboratory indicators (area under the ROC curve was 0.7).
time (TIR) (63-140 mg/dL (3.5-7.8 mmol/L)) and time above (TAR) (>140 mg/dL (>7.8 mmol/L)) are the most consistent CGM forecast indicators.
HbA1c is also a consistent predictor of the outcome of the second-best pregnancy.
some alternative laboratory indicators are more promising, but overall they are less predictable than HbA1c.
, HbA1c remains an important biological indicator of maternal and newborn outcomes during gestational periods of type 1 diabetes.
compared to the widely used HbA1c and the increasingly available CCM indicators (TIR and TAR), alternative blood sugar indicators and other CCM indicators did not significantly improve the predictive performance of pregnancy outcomes.
