OBJECTIVE To determine gestational weekly changes in continuous glucose monitoring (CGM) metrics and 24-h glucose profiles and their relationship to infant birth weight in pregnant women with type 1 diabetes. RESEARCH DESIGN AND METHODS An analysis of >10.5 million CGM glucose measures from 386 pregnant women with type 1 diabetes from two international multicenter studies was performed. CGM glucose metrics and 24-h glucose profiles were calculated for each gestational week, and the relationship to normal (10–90th percentile) and large (>90th percentile) for gestational age (LGA) birth weight infants was determined. RESULTS Mean CGM glucose concentration fell and percentage of time spent in the pregnancy target range of 3.5–7.8 mmol/L (63–140 mg/dL) increased in the first 10 weeks of pregnancy and plateaued until 28 weeks of gestation, before further improvement in mean glucose and percentage of time in range until delivery. Maternal CGM glucose metrics diverged at 10 weeks of gestation, with significantly lower mean CGM glucose concentration (7.1 mmol/L; 95% CI 7.05–7.15 [127.8 mg/dL; 95% CI 126.9–128.7] vs. 7.5 mmol/L; 95% CI 7.45–7.55 [135 mg/dL; 95% CI 134.1–135.9]) and higher percentage of time in range (55%; 95% CI 54–56 vs. 50%; 95% CI 49–51) in women who had normal versus LGA. The 24-h glucose profiles were significantly higher across the day from 10 weeks of gestation in LGA. CONCLUSIONS Normal birth weight is associated with achieving significantly lower mean CGM glucose concentration across the 24-h day and higher CGM time in range from before the end of the first trimester, emphasizing the need for a shift in clinical management, with increased focus on using weekly CGM glucose targets for optimizing maternal glycemia from early pregnancy.

中文翻译：

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连续血糖监测指标和出生体重：在整个怀孕期间通知 1 型糖尿病的管理

目的 确定 1 型糖尿病孕妇连续血糖监测 (CGM) 指标和 24 小时血糖曲线的妊娠周变化及其与婴儿出生体重的关系。研究设计和方法 对来自两项国际多中心研究的 386 名 1 型糖尿病孕妇的超过 1050 万 CGM 血糖测量值进行了分析。计算每个孕周的 CGM 葡萄糖指标和 24 小时葡萄糖曲线，并确定与正常胎龄 (LGA) 出生体重婴儿的正常（第 10-90 个百分位）和较大（>90 个百分位）的关系。结果 在妊娠的前 10 周，平均 CGM 葡萄糖浓度下降，在妊娠目标范围 3.5-7.8 mmol/L (63-140 mg/dL) 内花费的时间百分比增加，并在妊娠 28 周达到稳定水平，在进一步改善平均血糖和分娩前的范围内时间百分比之前。母体 CGM 葡萄糖指标在妊娠 10 周时出现差异，平均 CGM 葡萄糖浓度显着降低（7.1 mmol/L；95% CI 7.05–7.15 [127.8 mg/dL；95% CI 126.9–128.7] vs. 7.5 mmol/L； 95% CI 7.45–7.55 [135 mg/dL；95% CI 134.1–135.9]）和更高的范围内时间百分比（55%；95% CI 54–56 vs. 50%；95% CI 49–51）有正常与 LGA 的女性。从 LGA 妊娠 10 周开始，全天 24 小时血糖曲线显着升高。结