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- Title
Forty-eight-hour first-trimester glucose profiles in women with type 1 diabetes mellitus: a report of three cases of congenital malformation.
- Authors
Kerssen, Anneloes; de Valk, Harold W.; Visser, Gerard H. A.
- Abstract
Objective Despite modern methods of treatment and near-normal HbA1c levels, women with type 1 diabetes mellitus are still at risk of having an infant with a congenital malformation (CM). We hypothesised that HbA1c levels are too gross a measure of glycaemic control and used a continuous glucose monitoring system (CGMS) to determine the diurnal glucose profiles during the first trimester of pregnancy. We present three cases of infants with a CM. Methods Fifty-three women with type 1 diabetes used the CGMS for 48 h in the first trimester of pregnancy. Three of them gave birth to infants with a CM. HbA1c levels were determined at the time of the CGMS measurement and 6 to 8 weeks later. Results The HbA1c levels at the time of the CGMS measurement were 6.0, 6.5 and 7.8% (normal range 4.0-6.0%) in the three women. The 48-h diurnal glucose profiles of these women showed a large variability with frequent hyperglycaemic episodes. Conclusions HbA1c levels are too gross a measure of glycaemic control to identify women at risk of giving birth to an infant with a CM. Even in women with normal or near-normal HbA1c levels, the diurnal glucose profiles reveal intermittent hyperglycaemic episodes that may cause the CM. Copyright © 2006 John Wiley & Sons, Ltd.
- Publication
Prenatal Diagnosis, 2006, Vol 26, Issue 2, p123
- ISSN
0197-3851
- Publication type
Article
- DOI
10.1002/pd.1340