Document Detail


Fetal risk assessment in pregnancies complicated by diabetes mellitus.
MedLine Citation:
PMID:  21129331     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hypoglycemia and hyperglycemia can pose a number of serious risks to pregnant mothers with diabetes, but these risks are not always related to glucose concentrations directly. Previous studies have shown the utility of using mathematical transformation functions to create patient risk profiles that can then be used to analyze and predict adverse outcomes in individuals with diabetes. We propose a novel use of these functions to analyze the risks posed to the fetus in pregnancies complicated by diabetes.
METHODS: We retrospectively analyzed 71 h continuous glucose monitoring system (CGMS Gold, Medtronic Northridge, CA) third trimester tracings obtained during a normal pregnancy and in those complicated by gestational diabetes mellitus (GDM), type 2 diabetes mellitus (T2DM), and type 1 diabetes mellitus (T1DM). We then used a transformation function to calculate fetal and maternal risk in each case.
RESULTS: In the normal pregnancy (0.93), the risk was at a minimum. Along with mean glucose values, the risk increased in those cases where gestation was complicated by GDM (3.12), T2DM (7.85), and T1DM (16.94). In contrast, the original patient risk profile yielded a minimal value for the GDM tracings.
CONCLUSIONS: Total fetal risk increases from normal to GDM to T2DM to T1DM pregnancies. This new risk assignment better distinguishes the stages of fetal risk than the original method and therefore may be useful in future clinical trials and applications to predict risk for adverse outcomes in pregnancies complicated by diabetes.
Authors:
Howard C Zisser; Michael A Biersmith; Lois B Jovanovič; Yariv Yogev; Moshe Hod; Boris P Kovatchev
Publication Detail:
Type:  Journal Article     Date:  2010-11-01
Journal Detail:
Title:  Journal of diabetes science and technology     Volume:  4     ISSN:  1932-2968     ISO Abbreviation:  J Diabetes Sci Technol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-12-06     Completed Date:  2011-03-25     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  101306166     Medline TA:  J Diabetes Sci Technol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1368-73     Citation Subset:  IM    
Copyright Information:
© 2010 Diabetes Technology Society.
Affiliation:
Sansum Diabetes Research Institute, Santa Barbara, California 93105, USA. hzisser@sansum.org
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MeSH Terms
Descriptor/Qualifier:
Blood Glucose / metabolism*
Diabetes Complications / blood,  etiology*
Diabetes Mellitus, Type 1 / blood,  complications*
Diabetes Mellitus, Type 2 / blood,  complications*
Diabetes, Gestational* / blood
Female
Fetal Diseases / blood,  etiology*
Humans
Monitoring, Physiologic
Pregnancy
Pregnancy Trimester, Third / blood
Pregnancy in Diabetics*
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Chemical
Reg. No./Substance:
0/Blood Glucose
Comments/Corrections

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