JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
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Do HbA1c levels and the self-monitoring of blood glucose levels adequately reflect glycaemic control during pregnancy in women with type 1 diabetes mellitus?

Diabetologia 2006 January
AIMS/HYPOTHESIS: Pregnancies of women with type 1 diabetes mellitus are associated with maternal and perinatal complications. These complication rates remain elevated despite achievement of the treatment goals described in the widely used guidelines of the American Diabetes Association (i.e. HbA(1)c level
MATERIALS AND METHODS: We asked 43 pregnant women with type 1 diabetes to use the Continuous Glucose Monitoring System (CGMS) once in each trimester of pregnancy, while continuing their SMBG measurements. Glucose levels measured with the CGMS were compared between patients with HbA(1)c levels of 4.0-6.0%, 6.0-7.0% and >7.0%. Self-monitored glucose levels and those measured with CGMS were compared between patients with four or five, six to nine and ten or more SMBG determinations daily.

RESULTS: In patients with HbA(1)c levels 6.0%. In women with HbA(1)c levels 6.0-7.0% and >7.0%, these levels did not differ. The detection rate of hyper- and hypoglycaemic episodes was significantly higher in patients with ten or more SMBG determinations daily than in patients with fewer than ten.

CONCLUSIONS/INTERPRETATION: Treatment of diabetes in pregnant women should be aimed at achieving HbA(1)c levels within the normal range, i.e.

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