Episodic hyperglycaemia in pregnant women with well-controlled Type 1 diabetes mellitus: a major potential factor underlying macrosomia

Authors: Kyne-Grzebalski D.; Wood L.; Marshall S.M.; Taylor R.

Source: Diabetic Medicine, Volume 16, Number 8, August 1999 , pp. 702-706(5)

Publisher: Wiley-Blackwell

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Abstract:

Summary

Aims To test the common assumption that pregnant women who are sufficiently motivated to achieve very good HbA_1c levels will record home blood glucose data accurately.

Methods A new device was used to download information from electronic blood glucose meters to assess the extent of selectivity in patient glucose diary-keeping.

Results In an index case, a woman with excellent ambient HbA_1c (5.9%; upper limit of normal 6.1%) was observed to have 68% of preprandial blood glucose readings above the target range of 3.5–6.5 mmol/l and a mean (± sd) level of 8.9 ± 3.9 mmol/l in the corresponding period. No such impression was conveyed by the home monitoring diary. Six pregnant women with well controlled Type 1 diabetes (mean HbA_1c 6.6 ± 0.2%) exhibited between 42 and 68% of preprandial readings above the target range.

Conclusions The frequency of hyperglycaemia has hitherto been underestimated in well controlled pregnant women whose near-perfect home monitoring record is apparently corroborated by near-normal HbA_1c levels. These observations provide a hypothesis for understanding of the disappointing continuance of macrosomia despite excellent HbA_1c levels throughout pregnancy.

Keywords: glucose monitoring; hyperglycaemia; macrosomia; pregnancy; Type 1 diabetes mellitus

Language: English

Document Type: Miscellaneous

Publication date: 1999-08-01