OBJECTIVE To determine whether continuous glucose monitoring (CGM)-derived glycemic patterns can characterize pregnancies with gestational diabetes mellitus (GDM) as diagnosed by standard oral glucose tolerance test at 24–28 weeks’ gestation compared with those without GDM. RESEARCH DESIGN AND METHODS The analysis includes 768 individuals enrolled from two sites prior to 17 weeks’ gestation between June 2020 and December 2021 in a prospective observational study. Participants wore blinded Dexcom G6 CGMs throughout gestation. Main outcome of interest was a diagnosis of GDM by oral glucose tolerance test (OGTT). Glycemic levels in participants with GDM versus without GDM were characterized using CGM-measured glycemic metrics. RESULTS Participants with GDM (n = 58 [8%]) had higher mean glucose (109 ± 13 vs. 100 ± 8 mg/dL [6.0 ± 0.7 vs. 5.6 ± 0.4 mmol/L], P < 0.001), greater glucose SD (23 ± 4 vs. 19 ± 3 mg/dL [1.3 ± 0.2 vs. 1.1 ± 0.2 mmol/L], P < 0.001), less time in range 63–120 mg/dL (3.5–6.7 mmol/L) (70% ± 17% vs. 84% ± 8%, P < 0.001), greater percent time >120 mg/dL (>6.7 mmol/L) (median 23% vs. 12%, P < 0.001), and greater percent time >140 mg/dL (>7.8 mmol/L) (median 7.4% vs. 2.7%, P < 0.001) than those without GDM throughout gestation prior to OGTT. Median percent time >120 mg/dL (>6.7 mmol/L) and time >140 mg/dL (>7.8 mmol/L) were higher as early as 13–14 weeks of gestation (32% vs. 14%, P < 0.001, and 5.2% vs. 2.0%, P < 0.001, respectively) and persisted during the entire study period prior to OGTT. CONCLUSIONS Prior to OGTT at 24–34 weeks’ gestation, pregnant individuals who develop GDM have higher CGM-measured glucose levels and more hyperglycemia compared with those who do not develop GDM.

中文翻译：

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有或没有妊娠期糖尿病的妊娠期连续血糖监测概况

目的 确定连续血糖监测 (CGM) 衍生的血糖模式是否可以表征妊娠期糖尿病 (GDM) 的妊娠（通过妊娠 24-28 周时标准口服葡萄糖耐量试验诊断）与无 GDM 的妊娠相比。研究设计和方法 该分析纳入了 2020 年 6 月至 2021 年 12 月期间来自两个地点、妊娠 17 周之前的 768 名个体进行的前瞻性观察研究。参与者在整个妊娠期间佩戴盲法 Dexcom G6 CGM。感兴趣的主要结果是通过口服葡萄糖耐量试验（OGTT）诊断 GDM。使用 CGM 测量的血糖指标来表征 GDM 参与者与非 GDM 参与者的血糖水平。结果 GDM 参与者 (n = 58 [8%]) 的平均血糖较高（109 ± 13 vs. 100 ± 8 mg/dL [6.0 ± 0.7 vs. 5.6 ± 0.4 mmol/L]，P < 0.001），葡萄糖 SD（23 ± 4 vs. 19 ± 3 mg/dL [1.3 ± 0.2 vs. 1.1 ± 0.2 mmol/L]，P < 0.001），在 63–120 mg/dL 范围内的时间较短（3.5–6.7 mmol/L） L) (70% ± 17% vs. 84% ± 8%, P < 0.001)，更大百分比时间 > 120 mg/dL (> 6.7 mmol/L) (中位数 23% vs. 12%, P <与OGTT之前整个妊娠期间没有GDM的那些相比，＞140mg/dL(＞7.8mmol/L)的百分比时间更大(中位7.4％对2.7％，P＜0.001)。早在妊娠 13-14 周，中位百分比时间 >120 mg/dL (>6.7 mmol/L) 和时间 >140 mg/dL (>7.8 mmol/L) 就较高（32% 对比 14 周）。 ％，P＜0.001，和5.2％与2.0％，P＜0.001），并在OGTT之前的整个研究期间持续存在。结论 在妊娠 24-34 周进行 OGTT 之前，与未发生 GDM 的孕妇相比，发生 GDM 的孕妇 CGM 测量的血糖水平较高，高血糖也较多。