Introduction: Glycemic profiles of uncomplicated pregnancies throughout gestation are not well described, especially glycemic patterns after meals.
Methods: Participants were asked to wear blinded CGM throughout gestation, with a subset volunteering to record on a smartphone app the time meals began. Pregnancies without large for gestational age, hypertensive disorders, gestational diabetes based on OGTT, or HbA1c ≥5.7% defined uncomplicated pregnancies.
Results: Among 157 participants with uncomplicated pregnancies, mean fasting glucose was 88 ± 14 mg/dL, mean postprandial peak was 126 ± 22 mg/dL, and mean glucose excursion (<4 hours) was 36 ± 22 mg/dL; these metrics were similar throughout gestation. Median time to peak glucose was 62 (IQR: 40 to 124) min. Average glucose was 87, 89, and 94 mg/dL before breakfast, lunch, and dinner, respectively, but the excursion was similar across meals. Postprandial metrics were similar for those with vs. without LGA; however, in those with HDP, glycemic excursion was higher compared to participants without HDP (40 ± 22 vs. 36 ± 22 mg/dL, p<0.001, Table 1).
Conclusions: Postprandial glucose excursions during uncomplicated pregnancies demonstrate a relatively preserved time to peak glucose and amount of glucose excursion throughout gestation. Postprandial glucose excursions may be elevated in participants with HDP vs. without HDP.
A.L. Carlson: Research Support; Medtronic, Insulet Corporation, Tandem Diabetes Care, Inc., Eli Lilly and Company, Sanofi. Other Relationship; Novo Nordisk. Advisory Panel; MannKind Corporation. Research Support; Dexcom, Inc. Z. Li: None. R. Beck: Consultant; Insulet Corporation. Research Support; Insulet Corporation. Consultant; Tandem Diabetes Care, Inc. Research Support; Tandem Diabetes Care, Inc. Consultant; Beta Bionics, Inc. Research Support; Beta Bionics, Inc., Dexcom, Inc., Bigfoot Biomedical, Inc. Consultant; Novo Nordisk. Research Support; Novo Nordisk, Eli Lilly and Company. Consultant; embecta, Vertex Pharmaceuticals Incorporated, Hagar, Ypsomed AG, Sanofi, Zucara Therapeutics, Sequel. C. Durnwald: Consultant; Dexcom, Inc. Research Support; Dexcom, Inc. E. Norton: None. R.M. Bergenstal: Other Relationship; Abbott. Research Support; Arkray Marketing. Consultant; Ascensia Diabetes Care, Bigfoot Biomedical, Inc., CeQur. Other Relationship; Dexcom, Inc., Eli Lilly and Company. Consultant; embecta, Hygieia. Research Support; Insulet Corporation. Consultant; MannKind Corporation. Other Relationship; Medtronic, Novo Nordisk. Consultant; Onduo LLC, Roche Diabetes Care. Other Relationship; Sanofi. Research Support; Tandem Diabetes Care, Inc. Other Relationship; UnitedHealth Group. Consultant; Vertex Pharmaceuticals Incorporated, Zealand Pharma A/S. M.L. Johnson: Research Support; Abbott, Lilly Diabetes, National Institute of Diabetes and Digestive and Kidney Diseases, Novo Nordisk, Medtronic, Dexcom, Inc., Leona M. and Harry B. Helmsley Charitable Trust. Consultant; Jaeb Center for Health Research. Research Support; Patient-Centered Outcomes Research Institute, Jaeb Center for Health Research. S.M. Dunnigan: Research Support; Jaeb Center for Health Research, Patient-Centered Outcomes Research Institute, National Institute of Diabetes and Digestive and Kidney Diseases. M. Banfield: None. K.J. Krumwiede: None. J. Sibayan: None. P. Calhoun: None.
Study funding was provided by The Leona M. and Harry B. Helmsley and UnitedHealth Group. Dexcom provided the devices used in the study.
