Cargando…

Achieving the HbA(1c) Target Requires Longer Time in Range in Pregnant Women With Type 1 Diabetes

CONTEXT: Continuous glucose monitoring (CGM) overcomes the limitations of glycated hemoglobin (HbA(1c)). OBJECTIVE: This study aimed to investigate the relationship between CGM metrics and laboratory HbA(1c) in pregnant women with type 1 diabetes. METHODS: An observational study enrolled pregnant wo...

Descripción completa

Detalles Bibliográficos
Autores principales: Ling, Ping, Yang, Daizhi, Gu, Nan, Xiao, Xinhua, Lu, Jing, Liu, Fang, Zhou, Zhiguang, Huang, Qin, Zhao, Jiajun, Zhang, Mei, Hu, Ji, Luo, Sihui, Weng, Jianping, Yan, Jinhua, Zheng, Xueying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8530704/
https://www.ncbi.nlm.nih.gov/pubmed/34244734
http://dx.doi.org/10.1210/clinem/dgab502
_version_ 1784586722912239616
author Ling, Ping
Yang, Daizhi
Gu, Nan
Xiao, Xinhua
Lu, Jing
Liu, Fang
Zhou, Zhiguang
Huang, Qin
Zhao, Jiajun
Zhang, Mei
Hu, Ji
Luo, Sihui
Weng, Jianping
Yan, Jinhua
Zheng, Xueying
author_facet Ling, Ping
Yang, Daizhi
Gu, Nan
Xiao, Xinhua
Lu, Jing
Liu, Fang
Zhou, Zhiguang
Huang, Qin
Zhao, Jiajun
Zhang, Mei
Hu, Ji
Luo, Sihui
Weng, Jianping
Yan, Jinhua
Zheng, Xueying
author_sort Ling, Ping
collection PubMed
description CONTEXT: Continuous glucose monitoring (CGM) overcomes the limitations of glycated hemoglobin (HbA(1c)). OBJECTIVE: This study aimed to investigate the relationship between CGM metrics and laboratory HbA(1c) in pregnant women with type 1 diabetes. METHODS: An observational study enrolled pregnant women with type 1 diabetes who wore CGM devices during pregnancy and postpartum from 11 hospitals in China from January 2015 to June 2019. CGM data were collected to calculate time in range (TIR), time above range (TAR), time below range (TBR), and glycemic variability parameters. Relationships between the CGM metrics and HbA(1c) were explored. Linear and curvilinear regressions were conducted to investigate the best-fitting model to clarify the influence of HbA(1c) on the TIR-HbA(1c) relationship during pregnancy. RESULTS: A total of 272 CGM data and corresponding HbA(1c) from 98 pregnant women with type 1 diabetes and their clinical characteristics were analyzed in this study. Mean HbA(1c) and TIR were 6.49 ± 1.29% and 76.16 ± 17.97% during pregnancy, respectively. HbA(1c) was moderately correlated with TIR(3.5-7.8)(R = –0.429, P = .001), mean glucose (R = 0.405, P = .001) and TAR(7.8) (R = 0.435, P = .001), but was weakly correlated with TBR(3.5) (R = 0.034, P = .001) during pregnancy. On average, a 1% (11 mmol/mol) decrease in HbA(1c) corresponded to an 8.5% increase in TIR(3.5–7.8). During pregnancy, HbA(1c) of 6.0%, 6.5%, and 7.0% were equivalent to a TIR(3.5–7.8) of 78%, 74%, and 69%, respectively. CONCLUSION: We found there was a moderate correlation between HbA(1c) and TIR(3.5–7.8) during pregnancy. To achieve the HbA(1c) target of less than 6.0%, pregnant women with type 1 diabetes should strive for a TIR(3.5–7.8) of greater than 78% (18 hours 43 minutes) during pregnancy.
format Online
Article
Text
id pubmed-8530704
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-85307042021-10-25 Achieving the HbA(1c) Target Requires Longer Time in Range in Pregnant Women With Type 1 Diabetes Ling, Ping Yang, Daizhi Gu, Nan Xiao, Xinhua Lu, Jing Liu, Fang Zhou, Zhiguang Huang, Qin Zhao, Jiajun Zhang, Mei Hu, Ji Luo, Sihui Weng, Jianping Yan, Jinhua Zheng, Xueying J Clin Endocrinol Metab Online Only Articles CONTEXT: Continuous glucose monitoring (CGM) overcomes the limitations of glycated hemoglobin (HbA(1c)). OBJECTIVE: This study aimed to investigate the relationship between CGM metrics and laboratory HbA(1c) in pregnant women with type 1 diabetes. METHODS: An observational study enrolled pregnant women with type 1 diabetes who wore CGM devices during pregnancy and postpartum from 11 hospitals in China from January 2015 to June 2019. CGM data were collected to calculate time in range (TIR), time above range (TAR), time below range (TBR), and glycemic variability parameters. Relationships between the CGM metrics and HbA(1c) were explored. Linear and curvilinear regressions were conducted to investigate the best-fitting model to clarify the influence of HbA(1c) on the TIR-HbA(1c) relationship during pregnancy. RESULTS: A total of 272 CGM data and corresponding HbA(1c) from 98 pregnant women with type 1 diabetes and their clinical characteristics were analyzed in this study. Mean HbA(1c) and TIR were 6.49 ± 1.29% and 76.16 ± 17.97% during pregnancy, respectively. HbA(1c) was moderately correlated with TIR(3.5-7.8)(R = –0.429, P = .001), mean glucose (R = 0.405, P = .001) and TAR(7.8) (R = 0.435, P = .001), but was weakly correlated with TBR(3.5) (R = 0.034, P = .001) during pregnancy. On average, a 1% (11 mmol/mol) decrease in HbA(1c) corresponded to an 8.5% increase in TIR(3.5–7.8). During pregnancy, HbA(1c) of 6.0%, 6.5%, and 7.0% were equivalent to a TIR(3.5–7.8) of 78%, 74%, and 69%, respectively. CONCLUSION: We found there was a moderate correlation between HbA(1c) and TIR(3.5–7.8) during pregnancy. To achieve the HbA(1c) target of less than 6.0%, pregnant women with type 1 diabetes should strive for a TIR(3.5–7.8) of greater than 78% (18 hours 43 minutes) during pregnancy. Oxford University Press 2021-07-09 /pmc/articles/PMC8530704/ /pubmed/34244734 http://dx.doi.org/10.1210/clinem/dgab502 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Online Only Articles
Ling, Ping
Yang, Daizhi
Gu, Nan
Xiao, Xinhua
Lu, Jing
Liu, Fang
Zhou, Zhiguang
Huang, Qin
Zhao, Jiajun
Zhang, Mei
Hu, Ji
Luo, Sihui
Weng, Jianping
Yan, Jinhua
Zheng, Xueying
Achieving the HbA(1c) Target Requires Longer Time in Range in Pregnant Women With Type 1 Diabetes
title Achieving the HbA(1c) Target Requires Longer Time in Range in Pregnant Women With Type 1 Diabetes
title_full Achieving the HbA(1c) Target Requires Longer Time in Range in Pregnant Women With Type 1 Diabetes
title_fullStr Achieving the HbA(1c) Target Requires Longer Time in Range in Pregnant Women With Type 1 Diabetes
title_full_unstemmed Achieving the HbA(1c) Target Requires Longer Time in Range in Pregnant Women With Type 1 Diabetes
title_short Achieving the HbA(1c) Target Requires Longer Time in Range in Pregnant Women With Type 1 Diabetes
title_sort achieving the hba(1c) target requires longer time in range in pregnant women with type 1 diabetes
topic Online Only Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8530704/
https://www.ncbi.nlm.nih.gov/pubmed/34244734
http://dx.doi.org/10.1210/clinem/dgab502
work_keys_str_mv AT lingping achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT yangdaizhi achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT gunan achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT xiaoxinhua achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT lujing achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT liufang achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT zhouzhiguang achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT huangqin achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT zhaojiajun achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT zhangmei achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT huji achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT luosihui achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT wengjianping achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT yanjinhua achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes
AT zhengxueying achievingthehba1ctargetrequireslongertimeinrangeinpregnantwomenwithtype1diabetes