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- Title
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.
- Abstract
Summary Aims To test the common assumption that pregnant women who are sufficiently motivated to achieve very good HbA1c 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 HbA1c (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 HbA1c 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 HbA1c levels. These observations provide a hypothesis for understanding of the disappointing continuance of macrosomia despite excellent HbA1c levels throughout pregnancy.
- Subjects
BLOOD sugar monitoring; PREGNANCY complications; DIABETES complications
- Publication
Diabetic Medicine, 1999, Vol 16, Issue 8, p702
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1046/j.1464-5491.1999.00131.x