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Episodic hyperglycaemia in pregnant women with well-controlled Type 1 diabetes mellitus: a major potential factor underlying macrosomia

Lookup NU author(s): Professor Sally Marshall, Professor Roy Taylor

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Abstract

Aims To test the common assumption that pregnant women who are sufficiently motivated to achieve very good HbA(1c) 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 HbA(1c) (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 I diabetes (mean HbA(1c) 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 HbA(1c), levels. These observations provide a hypothesis for understanding of the disappointing continuance of macrosomia despite excellent HbA(1c) levels throughout pregnancy.


Publication metadata

Author(s): Taylor R; Marshall SM; Kyne-Grzebalski D; Wood L

Publication type: Article

Publication status: Published

Journal: Diabetic Medicine

Year: 1999

Volume: 16

Issue: 8

Pages: 702-706

Print publication date: 01/08/1999

ISSN (print): 0742-3071

ISSN (electronic): 1464-5491

Publisher: Wiley-Blackwell Publishing Ltd.

URL: http://dx.doi.org/10.1046/j.1464-5491.1999.00131.x

DOI: 10.1046/j.1464-5491.1999.00131.x


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