Demystifying Glycemic Variability in GDM Pregnancies: A Cross-Sectional Observational Study

To study glycemic variability (GV) and 24-h ambulatory glucose profile (AGP) in gestational diabetes mellitus (GDM) patients who were apparently controlled on drugs and their correlation with fetomaternal outcomes.

In this cross-sectional observational study, 40 gestational diabetic pregnancies on pharmacotherapy were recruited. Flash glucose monitor was used to record AGP between 32 and 36 weeks of gestation. A total of 600 patient days with 58,600 glucose values were analyzed.

Variables of GV: Mean amplitude of glycemic excursion (p = 0.001), standard deviation (p = 0.001), Continuous Overall Net Glycemic Action (p = 0.002) and High Blood Glucose Index (p = 0.001) were significantly high in GDM group when compared to normoglycemic patients and these were well correlated with poor fetomaternal outcome in this group. Time in range was also significantly altered in GDM group. (p < 0.001).

High GV and time in range are the important parameters which get altered in GDM pregnancies despite apparent control of blood glucose, and this can be a reason of adverse fetomaternal outcomes in these pregnancies.