{"title":"1971-LB: Contributions of Fasting and Postprandial Glucose Increments to Overall Hyperglycemia in Pregnant Women with Type 1 Diabetes","authors":"PING LING, DAIZHI YANG, CHAOFAN WANG, XUEYING ZHENG, SIHUI LUO, XUBIN YANG, HONGRONG DENG, WEN XU, JINHUA YAN, JIANPING WENG","doi":"10.2337/db24-1971-lb","DOIUrl":null,"url":null,"abstract":"Aims: To evaluate the relative contribution of fasting hyperglycemia (FHG) and postprandial hyperglycemia (PHG) to overall hyperglycemia across time in range (TIR) and glycated hemoglobin (HbA1c) categories in pregnant women with type 1 diabetes mellitus (T1DM). Materials and Methods: This observational study included 112 pregnant women with T1DM from the CARNATION study who wore continuous glucose monitoring (CGM) devices during pregnancy. The data from CGM were analyzed for TIR, AUC of PHG, AUC of FHG, FHG and PHG contribution rates. The levels of HbA1c (<6.0, 6.0-8.0, ≥8.0%) and TIR(<60, 60-78,≥78%) were categorized according to the guidelines, and the contribution of FHG and PHG to the overall hyperglycemia were compared. Results: A total of 295 CGM-HbA1c profiles were analyzed in this study. All women experienced a mean TIR of 75.6±19.0% and a mean HbA1c of 6.2±1.1% during pregnancy. The FHG contribution rates increased gradually with TIR decreasing [74.9(36.8, 100) vs. 69.1(13.4, 100) vs. 66.5 (10.0, 100), P<0.001] or with HbA1c increasing [57.8% (0, 100) vs. 72.7% (36.8, 100) vs. 80.7% (31.4, 100), P<0.001], whereas the contribution of PHG decreased progressively with diabetes worsening. Conclusions: FHG was the major contributor to hyperglycemia during pregnancy. Along with controlling the postprandial hyperglycemia, pregnant women with T1DM who did not reach the target of TIR or HbA1c may benefit more from the optimization of insulin regimens focusing on reducing the fasting hyperglycemia. Disclosure P. Ling: None. D. Yang: None. C. Wang: None. X. Zheng: None. S. Luo: None. X. Yang: None. H. Deng: None. W. Xu: None. J. Yan: None. J. Weng: None. Funding Science and Technology Planning Project of Guangzhou (grant/award number: 202102010154), Diabetes mellitus research fund program from Shanghai Medical and Health Development Foundation (grant/award number: DMRFP_II_14 from SHMHDF).","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"160 1","pages":""},"PeriodicalIF":6.2000,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2337/db24-1971-lb","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: To evaluate the relative contribution of fasting hyperglycemia (FHG) and postprandial hyperglycemia (PHG) to overall hyperglycemia across time in range (TIR) and glycated hemoglobin (HbA1c) categories in pregnant women with type 1 diabetes mellitus (T1DM). Materials and Methods: This observational study included 112 pregnant women with T1DM from the CARNATION study who wore continuous glucose monitoring (CGM) devices during pregnancy. The data from CGM were analyzed for TIR, AUC of PHG, AUC of FHG, FHG and PHG contribution rates. The levels of HbA1c (<6.0, 6.0-8.0, ≥8.0%) and TIR(<60, 60-78,≥78%) were categorized according to the guidelines, and the contribution of FHG and PHG to the overall hyperglycemia were compared. Results: A total of 295 CGM-HbA1c profiles were analyzed in this study. All women experienced a mean TIR of 75.6±19.0% and a mean HbA1c of 6.2±1.1% during pregnancy. The FHG contribution rates increased gradually with TIR decreasing [74.9(36.8, 100) vs. 69.1(13.4, 100) vs. 66.5 (10.0, 100), P<0.001] or with HbA1c increasing [57.8% (0, 100) vs. 72.7% (36.8, 100) vs. 80.7% (31.4, 100), P<0.001], whereas the contribution of PHG decreased progressively with diabetes worsening. Conclusions: FHG was the major contributor to hyperglycemia during pregnancy. Along with controlling the postprandial hyperglycemia, pregnant women with T1DM who did not reach the target of TIR or HbA1c may benefit more from the optimization of insulin regimens focusing on reducing the fasting hyperglycemia. Disclosure P. Ling: None. D. Yang: None. C. Wang: None. X. Zheng: None. S. Luo: None. X. Yang: None. H. Deng: None. W. Xu: None. J. Yan: None. J. Weng: None. Funding Science and Technology Planning Project of Guangzhou (grant/award number: 202102010154), Diabetes mellitus research fund program from Shanghai Medical and Health Development Foundation (grant/award number: DMRFP_II_14 from SHMHDF).
期刊介绍：
Diabetes is a scientific journal that publishes original research exploring the physiological and pathophysiological aspects of diabetes mellitus. We encourage submissions of manuscripts pertaining to laboratory, animal, or human research, covering a wide range of topics. Our primary focus is on investigative reports investigating various aspects such as the development and progression of diabetes, along with its associated complications. We also welcome studies delving into normal and pathological pancreatic islet function and intermediary metabolism, as well as exploring the mechanisms of drug and hormone action from a pharmacological perspective. Additionally, we encourage submissions that delve into the biochemical and molecular aspects of both normal and abnormal biological processes.
However, it is important to note that we do not publish studies relating to diabetes education or the application of accepted therapeutic and diagnostic approaches to patients with diabetes mellitus. Our aim is to provide a platform for research that contributes to advancing our understanding of the underlying mechanisms and processes of diabetes.
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