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

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 103; no. 7; pp. 1426 - 1436
• Main Authors: Englund Ögge, Linda, Dotevall, Annika, Elfvin, Anders, Sandgren, Ulrika, Linden, Karolina, Bohlin, Linnea, Wallstersson, Bernadette, Sjödell, Mårten, Augustinsson, Jaine, Hagman, Anna
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.07.2024; John Wiley and Sons Inc
• Subjects: continuous glucose monitoring; Diabetes; Glucose monitoring; glycemic control; large for gestational age; Obstetrics, Gynecology and Reproductive Medicine; Original; Preeclampsia; Pregnancy; preterm delivery; Reproduktionsmedicin och gynekologi; time above target; time below target; time in target; type 1 diabetes; time above target; type 1 diabetes; glycemic control; pregnancy; time in target; large for gestational age; preeclampsia; continuous glucose monitoring; time below target; preterm delivery
• ISSN: 0001-6349; 1600-0412; 1600-0412
• DOI: 10.1111/aogs.14856

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. This study showed that women with diabetes improved their glycemic control during pregnancy; however, there were no significant differences in glycemic control in women developing preeclampsia compared to women who did not develop preeclampsia. Larger studies are needed.