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. 2023 Mar 9;18(3):e0282895.
doi: 10.1371/journal.pone.0282895. eCollection 2023.

Correlations between parameters of glycaemic variability and foetal growth, neonatal hypoglycaemia and hyperbilirubinemia in women with gestational diabetes

Immacolata Blasi  1 , Jessica Daolio  1 , Valeria Pugni  2 , Giuseppina Comitini  1 , Marcello Morciano  3   4 , Giorgio Grassi  5 , Tullia Todros  6 , Giancarlo Gargano  7 , Lorenzo Aguzzoli  1
Affiliations

Correlations between parameters of glycaemic variability and foetal growth, neonatal hypoglycaemia and hyperbilirubinemia in women with gestational diabetes

Immacolata Blasi et al. PLoS One. .

Abstract

The diagnosis of gestational diabetes mellitus (GDM) is important to prevent maternal and neonatal complications. This study aimed to investigate the feasibility of parameters of glycaemic variability to predict neonatal complications in women with GDM. A retrospective study was conducted on pregnant women tested positive at the oral glucose tolerance test (OGTT) during 16-18 or 24-28 weeks of gestation. Glycaemic measures were extracted from patients' glucometers and expanded to obtain parameters of glycaemic variability. Data on pregnancy outcomes were obtained from clinical folders. Descriptive group-level analysis was used to assess trends in glycaemic measures and foetal outcomes. Twelve patients were included and analysed, accounting for 111 weeks of observations. The analysis of trends in parameters of glycaemic variability showed spikes of glycaemic mean, high blood glucose index and J-index at 30-31 weeks of gestation for cases with foetal macrosomia, defined as foetal growth >90° percentile, neonatal hypoglycaemia and hyperbilirubinemia. Specific trends in parameters of glycaemic variability observed at third trimester correlate with foetal outcomes. Further research is awaited to provide evidence that monitoring of glycaemic variability trends could be more clinically informative and useful than standard glycaemic checks to manage women with GDM at delivery.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Trends in parameters of glycaemic variability by foetal growth.
GM = Glycaemic Mean; GMV = Glycaemic Mean Value; HBGI = High Blood Glucose Index; LBGI = Low Blood Glucose Index; MAG = Mean Absolute Glucose; MAGE = Mean Amplitude of Glucose Excursions; SD = Standard Deviation. Adjusted values reported (see the Statistical analysis sub-section for details).
Fig 2
Fig 2. Trends in parameters of glycaemic variability by neonatal hypoglycaemia.
GM = Glycaemic Mean; GMV = Glycaemic Mean Value; HBGI = High Blood Glucose Index; LBGI = Low Blood Glucose Index; MAG = Mean Absolute Glucose; MAGE = Mean Amplitude of Glucose Excursions; SD = Standard Deviation. Adjusted values reported (see the Statistical analysis sub-section for details).
Fig 3
Fig 3. Trends in parameters of glycaemic variability by neonatal hyperbilirubinemia.
GM = Glycaemic Mean; GMV = Glycaemic Mean Value; HBGI = High Blood Glucose Index; LBGI = Low Blood Glucose Index; MAG = Mean Absolute Glucose; MAGE = Mean Amplitude of Glucose Excursions; SD = Standard Deviation. Adjusted values reported (see the Statistical analysis sub-section for details).
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