Characteristics of glycemic excursions in pregnant women with gestational diabetes mellitus

Objective To analyze the characteristics of glycemic excursions in pregnant women with gestational diabetes mellitus (GDM) by continuous glucose monitoring system (CGMS).Methods 49 newly diagnosed GDM patients were enrolled in this study.The within-day,day-to-day,and postprandial glucose excursions were evaluated retrospectively by CGMS for 72 hours.Results The mean plasma glucose (MPG) and mean amplitude of glucose excursions (MAGE) were(5.75±0.82)mmol/L and (4.86±1.03)mmol/L respectively.MAGE had a significantly positive correlation with postprandial glucose excursions (PPGE) at breakfast,and postprandial glucose spike (PGS)(r=0.45、0.45、0.46、0.46,P0.001,respectively).CV of fasting plasma glucose (CV-FPG) was (18.70±4.92)%,and had a positive correlation with PPGE(r=0.37、0.30、0.41,P=0.01、0.035、0.005,respectively).PGS was higher (8.87 ±1.09) mmol/L,and time to PGS (t) was sooner(76.9±5.71)min at breakfast than those at lunch and dinner,and PPGE was (3.27±1.03) mmol/L.The incidence of nocturnal unrecognized hypoglycemic events is 31.0 %.Conclusions The within-day,day-to-day,postprandial glucose excursions and the incidence of nocturnal unrecognized hypoglycemic events in pregnant women with GDM are high.The features of postprandial glucose state are representative high PGS,delay of PGS,especially at breakfast.