Real-time continuous glucose monitoring during labour and delivery in women with Type 1 diabetes — observations from a randomized controlled trial

Authors

  • S. Cordua,

    1. Center for Pregnant Women with Diabetes, University of Copenhagen, Copenhagen, Denmark
    2. Department of Endocrinology, University of Copenhagen, Copenhagen, Denmark
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    • These authors are joint first authors of this article.
  • A. L. Secher,

    Corresponding author
    1. Center for Pregnant Women with Diabetes, University of Copenhagen, Copenhagen, Denmark
    2. Department of Endocrinology, University of Copenhagen, Copenhagen, Denmark
    3. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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    • These authors are joint first authors of this article.
  • L. Ringholm,

    1. Center for Pregnant Women with Diabetes, University of Copenhagen, Copenhagen, Denmark
    2. Department of Endocrinology, University of Copenhagen, Copenhagen, Denmark
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  • P. Damm,

    1. Center for Pregnant Women with Diabetes, University of Copenhagen, Copenhagen, Denmark
    2. Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
    3. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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  • E. R. Mathiesen

    1. Center for Pregnant Women with Diabetes, University of Copenhagen, Copenhagen, Denmark
    2. Department of Endocrinology, University of Copenhagen, Copenhagen, Denmark
    3. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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  • (Clinical Trials Registry No; NCT 00994357)

Abstract

Aims

To explore whether real-time continuous glucose monitoring during labour and delivery supplementary to hourly self-monitored plasma glucose in women with Type 1 diabetes reduces the prevalence of neonatal hypoglycaemia.

Methods

Women with Type 1 diabetes participating in a randomized controlled trial on the effect of real-time continuous glucose monitoring in pregnancy were included in this study. Twenty-seven of 60 (45%) women in the intervention arm used real-time continuous glucose monitoring during labour and delivery, supplementary to hourly self-monitored plasma glucose. Real-time continuous glucose monitoring glucose data covering the last 8 h prior to delivery were retrospectively evaluated, and maternal hypo- and hyperglycaemia were defined as glucose values ≤ 3.9 mmol/l and > 7.0 mmol/l, respectively. Women in the control arm (n = 59) solely used self-monitored plasma glucose. Neonatal hypoglycaemia was defined as a 2-h plasma glucose < 2.5 mmol/l.

Results

In infants of women using real-time continuous glucose monitoring during labour and delivery, 10 (37%) developed neonatal hypoglycaemia vs. 27 (46%) infants in the control arm (P = 0.45). Among 10 infants with and 17 infants without neonatal hypoglycaemia within the real-time continuous glucose monitoring arm, median maternal self-monitored plasma glucose was 6.2 (range 4.2–7.8) vs. 5.6 (3.3–8.5) mmol/l (P = 0.26) during labour and delivery, with maternal hyperglycaemia present in 17 (0–94) vs. 4 (0–46)% of the time (P = 0.02), and birthweight was 4040 (3102–4322) vs. 3500 (1829–4320) g (P = 0.04). Maternal hypoglycaemia up to delivery was relatively rare.

Conclusions

The prevalence of neonatal hypoglycaemia was comparable between infants of women using real-time continuous glucose monitoring supplementary to self-monitored plasma glucose during labour and delivery and infants of women solely using self-monitored plasma glucose.

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