Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort study

Abstract Introduction Women with type 1 diabetes have an increased risk of preeclampsia (PE), but it is not fully understood if degree of glycemic control is associated with this risk. The aim of this study was to assess glycemic control during pregnancy analyzed by continuous glucose monitoring (CG...

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Main Authors: Linda Englund Ögge, Annika Dotevall, Anders Elfvin, Ulrika Sandgren, Karolina Linden, Linnea Bohlin, Bernadette Wallstersson, Mårten Sjödell, Jaine Augustinsson, Anna Hagman
Format: Article
Language:English
Published: Wiley 2024-07-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14856
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author Linda Englund Ögge
Annika Dotevall
Anders Elfvin
Ulrika Sandgren
Karolina Linden
Linnea Bohlin
Bernadette Wallstersson
Mårten Sjödell
Jaine Augustinsson
Anna Hagman
author_facet Linda Englund Ögge
Annika Dotevall
Anders Elfvin
Ulrika Sandgren
Karolina Linden
Linnea Bohlin
Bernadette Wallstersson
Mårten Sjödell
Jaine Augustinsson
Anna Hagman
author_sort Linda Englund Ögge
collection DOAJ
description Abstract Introduction Women with type 1 diabetes have an increased risk of preeclampsia (PE), but it is not fully understood if degree of glycemic control is associated with this risk. The aim of this study was to assess glycemic control during pregnancy analyzed by continuous glucose monitoring (CGM) in women with and without PE and to investigate if glycemic control is associated with increased risk of PE. Material and Methods A total of 120 pregnant Swedish women with type 1 diabetes using CGM were included. Background factors and pregnancy outcomes were collected from medical records. CGM data were collected via the internet‐based platform Diasend. Mean glucose, standard deviation of mean glucose, percentage of time in target, time below target, and time above target were presented for each trimester in women who did or did not develop PE. Associations between CGM‐derived metrics and PE were analyzed with logistic regression and adjusted for confounders. Results Twenty‐two women (18.3%) developed PE. There were no significant differences in maternal characteristics between women with and without PE. Glycemic control improved in each trimester but was suboptimal in both groups. Time in target increased from 59% in the non‐PE group and 54% in the PE group in the first trimester to 65% in both groups in the third trimester. There were no significant associations between glycemic control and PE after adjustment for confounders. Conclusions Degree of glycemic control during pregnancy assessed by CGM was not associated with development of PE in women with type 1 diabetes. However, more research is needed to understand the role of glycemic control in relation to development of PE.
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spelling doaj-art-01e300699d4e44459d85f0834d501e982025-08-20T02:36:34ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-07-0110371426143610.1111/aogs.14856Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort studyLinda Englund Ögge0Annika Dotevall1Anders Elfvin2Ulrika Sandgren3Karolina Linden4Linnea Bohlin5Bernadette Wallstersson6Mårten Sjödell7Jaine Augustinsson8Anna Hagman9Department of Obstetrics and Gynecology Sahlgrenska University Hospital/Östra Gothenburg SwedenDepartment of Medicine Sahlgrenska University Hospital/Östra Gothenburg SwedenDepartment of Pediatrics Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg Gothenburg SwedenDepartment of Obstetrics and Gynecology Sahlgrenska University Hospital/Östra Gothenburg SwedenInstitute of Health and Care Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg SwedenRegionhälsan Health Care, Gynecology and Obstetrics Clinic Gothenburg SwedenDepartment of Obstetrics and Gynecology Sahlgrenska University Hospital/Östra Gothenburg SwedenDepartment of Obstetrics and Gynecology Skaraborg Hospital Skövde SwedenRegionhälsan Health Care, Gynecology and Obstetrics Clinic Gothenburg SwedenRegionhälsan Health Care, Gynecology and Obstetrics Clinic Gothenburg SwedenAbstract Introduction Women with type 1 diabetes have an increased risk of preeclampsia (PE), but it is not fully understood if degree of glycemic control is associated with this risk. The aim of this study was to assess glycemic control during pregnancy analyzed by continuous glucose monitoring (CGM) in women with and without PE and to investigate if glycemic control is associated with increased risk of PE. Material and Methods A total of 120 pregnant Swedish women with type 1 diabetes using CGM were included. Background factors and pregnancy outcomes were collected from medical records. CGM data were collected via the internet‐based platform Diasend. Mean glucose, standard deviation of mean glucose, percentage of time in target, time below target, and time above target were presented for each trimester in women who did or did not develop PE. Associations between CGM‐derived metrics and PE were analyzed with logistic regression and adjusted for confounders. Results Twenty‐two women (18.3%) developed PE. There were no significant differences in maternal characteristics between women with and without PE. Glycemic control improved in each trimester but was suboptimal in both groups. Time in target increased from 59% in the non‐PE group and 54% in the PE group in the first trimester to 65% in both groups in the third trimester. There were no significant associations between glycemic control and PE after adjustment for confounders. Conclusions Degree of glycemic control during pregnancy assessed by CGM was not associated with development of PE in women with type 1 diabetes. However, more research is needed to understand the role of glycemic control in relation to development of PE.https://doi.org/10.1111/aogs.14856continuous glucose monitoringglycemic controllarge for gestational agepreeclampsiapregnancypreterm delivery
spellingShingle Linda Englund Ögge
Annika Dotevall
Anders Elfvin
Ulrika Sandgren
Karolina Linden
Linnea Bohlin
Bernadette Wallstersson
Mårten Sjödell
Jaine Augustinsson
Anna Hagman
Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort study
Acta Obstetricia et Gynecologica Scandinavica
continuous glucose monitoring
glycemic control
large for gestational age
preeclampsia
pregnancy
preterm delivery
title Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort study
title_full Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort study
title_fullStr Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort study
title_full_unstemmed Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort study
title_short Glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia, an observational Swedish cohort study
title_sort glycemic control assessed by continuous glucose monitoring during pregnancy in women with type 1 diabetes and its association with preeclampsia an observational swedish cohort study
topic continuous glucose monitoring
glycemic control
large for gestational age
preeclampsia
pregnancy
preterm delivery
url https://doi.org/10.1111/aogs.14856
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