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New Glycemic Control Targets In Pregnancy May Be Needed


 

PRAGUE — Normative values for mean blood glucose levels during the first trimester may be much lower than previously believed, Dr. Yariv Yogev reported at the 20th European Congress of Perinatal Medicine.

This lower-than-expected glycemic profile may suggest new targets for glycemic control during pregnancy complicated by diabetes, said Dr. Yogev of the department of obstetrics and gynecology at Rabin Medical Center, Petah Tikva, Israel.

The study included 62 healthy, nondiabetic women in their first trimester of pregnancy (average of 10 weeks' gestation). The investigators fit the women with continuous glucose monitoring devices that measured their blood glucose levels every 5 minutes for 72 hours.

The overall mean blood glucose (79.3 mg/dL) and mean fasting blood glucose levels (75 mg/dL) were “much, much lower than was previously reported by others.” Mean nighttime blood glucose levels (66 mg/dL) “almost represented hypoglycemia,” but such values may actually represent “normal physiology during the first trimester in nondiabetic patients,” he said.

The postprandial glycemic profile of the women was the same after each meal. Mean blood glucose values started at 79 mg/dL just before a meal and rose to 106 mg/dL 60 minutes after the meal; it reached a high of 112 mg/dL 74 minutes after the meal. The values reached 99 mg/dL at 2 hours and 82 mg/dL at 3 hours.

The fasting and overall mean blood glucose levels were similar in 18 obese (defined as a body mass index greater than 27.3 kg/m

The women as a whole were at least one standard deviation below the recommended threshold for the treatment of diabetes during pregnancy, he said.

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