DETERMINING THE IMPORTANCE OF GLYCEMIC VARIABILITY IN GESTATIONAL DIABETES MELLITUS USING VARIOUS TECHNIQUES GESTASYONEL DİABETES MELLİTUSTA GLİSEMİK DEĞİŞKENLİKLERİN ÖNEMİ VE FARKLI YÖNTEMLERLE ARAŞTIRILMASI


Öztop N., Kubat Üzüm A., Çelik S., Idiz C., Tütüncü Y., Bağdemir E., ...Daha Fazla

Istanbul Tip Fakultesi Dergisi, cilt.86, sa.1, ss.44-51, 2023 (Scopus) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 86 Sayı: 1
  • Basım Tarihi: 2023
  • Doi Numarası: 10.26650/iuitfd.1193997
  • Dergi Adı: Istanbul Tip Fakultesi Dergisi
  • Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.44-51
  • Anahtar Kelimeler: 1.5-anhydroglucitol, fructosamine, Gestational diabetes, glycemic variability, HbA1c
  • İstanbul Üniversitesi Adresli: Evet

Özet

Objective: The study aims to determine glycemic variation in patients with gestational diabetes mellitus (GDM) and to evaluate the effect on the fetal growth using a continuous glucose monitoring system (CGMS) and to investigate the correlation between glucose variation through biomarkers including HbA1c, fructosamine (FRM), and 1.5-Anhydroglucitol (1.5-AG). Materials and Methods: The study involves 31 women with GDM at gestational week ≥35 who'd only had diet therapy. Blood glucose levels were monitored for three consecutive days using CGMS to evaluate mean blood glucose levels and mean absolute difference (MAD). Self-monitoring of blood glucose (SMBG) was required from the patients while having the CMGS on their body. Blood samples were collected to measure serum 1.5-AG, HbA1c, and FRM. Results: The mean levels were HbA1c=5.0±0.3%, FRM=2.1±0.2 μmol/L, 1.5-AG=17.0±4.9 ng/ml, and 3-day average max-min glucose range=131.1±22.5 and 54.7±11.6 mg/dl (MAD=6.7±3.1%). The mean glucose levels measured using SMBG and CGMS were similar (82.9±10.2 vs 86.1±10.3 mg/dL). No correlation occurred between CMGS and biomarkers. The baby weight at birth and head circumference was determined to be lower for patients with glucose fluctuations. Conclusion: Biomarkers do not reflect glycemic fluctuation, and regular SMBG is required to achieve the desired glucose level, even in diet-regulated GDM. Lower head circumference and birth weight were determined in GDM mothers with high glycemic fluctuations, and CGMS may be an alternative method despite its cost and application difficulties.