Despite recent advances in care, women with diabetes in pregnancy are still at increased risk of multiple pregnancy complications. Offspring exposed to hyperglycaemia in utero also experience long-term health sequelae affecting neurocognitive and cardiometabolic status. Many of these adverse consequences can be prevented or ameliorated with good medical care, specifically to optimise glycaemic control. The accurate assessment of glycaemia in pregnancy is therefore vital to safeguard the health of mother and child.

However, there is no consensus about the best method of monitoring glycaemic control in pregnancy. Short-term changes in insulin dosage and lifestyle, with altered appetite, insulin sensitivity and red cell turnover create difficulties in interpretation of standard laboratory measures such as HbA1c. The ideal marker would provide short-term feedback on daily or weekly glycaemic control, with additional capability to predict pregnancies at high risk of suboptimal outcomes. Several novel biochemical markers are available which allow assessment of dynamic changes in glycaemia over weeks rather than months. Continuous glucose monitoring devices have advanced in accuracy and provide new opportunities for robust assessment of glycaemia in pregnancy. Recent work from the continuous glucose monitoring in pregnant women with type 1 diabetes trial (CONCEPTT) has provided information about the ability of different markers of glycaemia to predict pregnancy outcomes.

The aim of this review is to summarise the care for women with pre-existing diabetes in pregnancy, and to highlight the important role of glycaemic monitoring in pregnancy.

尽管最近在护理方面取得了进展，但妊娠期糖尿病妇女发生多胎妊娠并发症的风险仍然增加。在子宫内暴露于高血糖的后代也会经历影响神经认知和心脏代谢状态的长期健康后遗症。许多这些不良后果可以通过良好的医疗护理来预防或改善，特别是优化血糖控制。因此，准确评估孕期血糖对保障母婴健康至关重要。

然而，关于监测妊娠期血糖控制的最佳方法尚无共识。胰岛素剂量和生活方式的短期变化，以及食欲、胰岛素敏感性和红细胞更新率的改变，给解释标准实验室测量值（如 HbA1c）带来了困难。理想的标志物将提供每日或每周血糖控制的短期反馈，并具有额外的能力来预测处于次优结果高风险的妊娠。有几种新的生化标志物可用，它们可以在数周而不是数月内评估血糖的动态变化。连续血糖监测设备的准确性有所提高，并为可靠地评估妊娠期血糖提供了新的机会。

本综述的目的是总结妊娠期糖尿病患者的护理，并强调血糖监测在妊娠期的重要作用。