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Association Between CGM Metrics in Type 2 Diabetes Pregnancy and Perinatal Morbidity

Not yet recruiting
Conditions
Type 2 Diabetes Mellitus (T2DM)
Pregnancy
Interventions
Biological: Exposure to hyperglycemia (type 2 diabetes)
Registration Number
NCT06892314
Lead Sponsor
Centre Hospitalier Sud Francilien
Brief Summary

The purpose of this observational study is to measure the association between continuous glucose monitoring (CGM) parameters and perinatal morbidity in offspring of women with type 2 diabetes. Specifically, the study will assess whether gestational age interacts with metabolic control in influencing perinatal morbidity, as well as the impact of the timing of CGM initiation during pregnancy.

Detailed Description

Continuous glucose monitoring (CGM) data in pregnant women living with type 2 diabetes (T2D) and its association with perinatal morbidity are very recent and remain scarce. Moreover, perinatal morbidity appears to differ in these patients compared to pregnancies affected by type 1 diabetes or gestational diabetes.

As a result, a deeper understanding is needed to identify the most relevant glycemic parameters and, in particular, the gestational age most critical for metabolic control.

Furthermore, uncertainty remains regarding the benefits of early CGM use in this population, which is characterized by early-onset T2D. A description of this population in the French context is therefore of particular interest.

This single-centre observational study will consist of a retrospective cohort of patients with type 2 diabetes and pregnancy with pregnancy follow-up and delivery at the Centre Hospitalier Sud-Francilien between 1 January 2020 and 31 January 2025.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
Female
Target Recruitment
120
Inclusion Criteria
  • Adult patient
  • Patient diagnosed with type 2 diabetes before or during pregnancy (fasting blood glucose > 126 mg/dL, blood glucose > 200 mg/dL after an oral glucose tolerance test, or HbA1c > 6.5%)
  • Patient who has undergone continuous glucose monitoring at least once during pregnancy
Exclusion Criteria
  • Multiple pregnancy
  • Pregnancy terminated before 20 weeks of amenorrhea
  • Delivery outside CHSF
  • Patient and/or legal guardians of the newborn who objected to the use of data

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
PatientsExposure to hyperglycemia (type 2 diabetes)-
Primary Outcome Measures
NameTimeMethod
time in range (63-140 mg/dL) in pourcentageup to delivery

Correlation between time in range (63-140 mg/dL) during pregnancy and perinatal risk, assessed using a composite outcome including preterm birth, birth weight \> 90th percentile for gestational age, neonatal hypoglycemia, shoulder dystocia, neonatal resuscitation, neonatal hyperbilirubinemia, and perinatal mortality.

preterm birth : yes or noat delivery

Correlation between time in range (63-140 mg/dL) during pregnancy and perinatal risk, assessed using a composite outcome including preterm birth, birth weight \> 90th percentile for gestational age, neonatal hypoglycemia, shoulder dystocia, neonatal resuscitation, neonatal hyperbilirubinemia, and perinatal mortality.

birth weight in kilogrammeat delivery

Correlation between time in range (63-140 mg/dL) during pregnancy and perinatal risk, assessed using a composite outcome including preterm birth, birth weight \> 90th percentile for gestational age, neonatal hypoglycemia, shoulder dystocia, neonatal resuscitation, neonatal hyperbilirubinemia, and perinatal mortality.

neonatal hypoglycemia : yes or noat delivery

Correlation between time in range (63-140 mg/dL) during pregnancy and perinatal risk, assessed using a composite outcome including preterm birth, birth weight \> 90th percentile for gestational age, neonatal hypoglycemia, shoulder dystocia, neonatal resuscitation, neonatal hyperbilirubinemia, and perinatal mortality.

shoulder dystocia : yes or noat delivery

Correlation between time in range (63-140 mg/dL) during pregnancy and perinatal risk, assessed using a composite outcome including preterm birth, birth weight \> 90th percentile for gestational age, neonatal hypoglycemia, shoulder dystocia, neonatal resuscitation, neonatal hyperbilirubinemia, and perinatal mortality.

neonatal resuscitation : yes or noat delivery

Correlation between time in range (63-140 mg/dL) during pregnancy and perinatal risk, assessed using a composite outcome including preterm birth, birth weight \> 90th percentile for gestational age, neonatal hypoglycemia, shoulder dystocia, neonatal resuscitation, neonatal hyperbilirubinemia, and perinatal mortality.

perinatal mortality : yes or noat delivery

Correlation between time in range (63-140 mg/dL) during pregnancy and perinatal risk, assessed using a composite outcome including preterm birth, birth weight \> 90th percentile for gestational age, neonatal hypoglycemia, shoulder dystocia, neonatal resuscitation, neonatal hyperbilirubinemia, and perinatal mortality.

Secondary Outcome Measures
NameTimeMethod
mean glucose (mmol/L)up to delivery

Correlation between characteristics of pregnant patients with T2D and their newborns, including diabetes management and delivery details

time in range (less than 63 mg/dL) in pourcentageup to delivery

Correlation between characteristics of pregnant patients with T2D and their newborns, including diabetes management and delivery details

glucose management indicator in pourcentageup to delivery

Correlation between distribution of characteristics of pregnant patients with T2D and their newborns, including diabetes management and delivery details

glycemic coefficient of variation in pourcentageup to delivery

Correlation between distribution of characteristics of pregnant patients with T2D and their newborns, including diabetes management and delivery details

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