Glycemic Profiles and Pregnancy Outcomes Study (GLOSS)

血糖曲线和妊娠结局研究 (GLOSS)

• 批准号: 10704001
• 负责人: William L Lowe
• 金额: $ 71.34万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10704001
• 关键词: Address; Admission activity; Adverse effects; Birth; Birth trauma; Blood Glucose; Cardiovascular Diseases; Cesarean section; Child; Childhood; Clinical; Clinical Trials; Continuous Glucose Monitor; Data; Data Analyses; Development; Diabetes Mellitus; Diagnosis; Diagnostic; Dystocia; Early Diagnosis; Evaluation; Evolution; First Pregnancy Trimester; Frequencies; Future; Gestational Age; Gestational Diabetes; Glucose; Health; Hour; Hyperglycemia; Hypertension; Hypoglycemia; Intervention; Low Birth Weight Infant; Measures; Metabolic; Metabolic Diseases; Natural History; Neonatal; Neonatal Hypoglycemia; Neonatal Intensive Care Units; Newborn Infant; OGTT; Obesity; Outcome; Outcome Study; Pattern; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prevalence; Randomized; Risk; Shoulder; Suggestion; Third Pregnancy Trimester; Time; Woman; advanced analytics; adverse maternal outcomes; adverse outcome; adverse pregnancy outcome; clinically relevant; cohort; early pregnancy; experience; fasting glucose; glucose monitor; high risk; insight; maternal hyperglycemia; maternal outcome; neonatal outcome; newborn adiposity; novel strategies; pregnancy disorder; success; therapy design

PROJECT SUMMARY The prevalence of gestational diabetes mellitus (GDM) has increased substantially over the past two decades. This increased prevalence is of concern given the association of GDM with adverse pregnancy outcomes as well as longer-term adverse outcomes for both women and their children. Identification and treatment of GDM are clinically important, as treatment can lessen the frequency of at least some — but not all — adverse outcomes. One potential explanation for the inconsistent relationship of GDM treatment to the reduction of adverse maternal, neonatal, and childhood outcomes is that GDM diagnosis and treatment typically occur in the third trimester, which may be too late to ameliorate all of the adverse effects associated with maternal dysglycemia. However, efforts to identify clinically relevant maternal dysglycemia earlier in gestation, such as the first trimester, or to predict who will subsequently develop GDM, have not been successful. One reason for this lack of success is that the evaluation of glucose levels during pregnancy has primarily involved singular measures of fasting glucose or only a few glucose levels following a glucose load. Such measures may provide limited insight into a maternal glycemic state that is in flux both in the short and long term. Continuous glucose monitoring (CGM) provides an opportunity to evaluate glucose profiles and gain information related to how these profiles change longitudinally over hours, days, weeks, and months. In this proposal, we will address the hypothesis that maternal glucose signatures, starting early in pregnancy, will predict the subsequent diagnosis of GDM and be better associated with maternal and newborn outcomes than the third-trimester diagnosis of GDM. To address this hypothesis, we will use data from CGM to examine glycemic patterns during pregnancy, and analyze these patterns to determine how strongly they are associated with the subsequent development of GDM as well as adverse maternal and neonatal outcomes. The proposed study will define the evolution of glucose levels during pregnancy in women without diabetes mellitus, and define patterns of glycemia in early pregnancy that identify women who will progress to GDM and/or who will be more likely to have maternal and neonatal adverse outcomes. These data are crucial to help determine future clinical trials and interventions to reduce short- and long-term adverse pregnancy outcomes.

项目摘要 妊娠期糖尿病（GDM）的患病率在过去二十年中大幅增加。 考虑到妊娠期糖尿病与不良妊娠结局的相关性， 对妇女和她们的孩子都有长期的不利影响。GDM的识别和治疗 临床上很重要，因为治疗可以减少至少一些-但不是所有-不良结果的频率。 GDM治疗与不良反应减少之间不一致的一种可能解释是， 孕产妇，新生儿和儿童的结果是，GDM的诊断和治疗通常发生在第三个 三个月，这可能为时已晚，以改善所有的不利影响与母亲的精神障碍。 然而，在妊娠早期（如前三个月）确定临床相关的母体精神障碍的努力， 或预测谁将随后发展GDM，都没有成功。这种不成功的原因之一 妊娠期间血糖水平的评估主要涉及禁食的单一措施， 在葡萄糖负荷后，葡萄糖水平可以降低或仅降低几个葡萄糖水平。这些措施可能会提供有限的洞察力， 母亲的血糖状态在短期和长期都在变化。动态血糖监测（CGM） 提供了评估葡萄糖曲线并获得与这些曲线如何变化相关的信息的机会 在数小时、数天、数周和数月内纵向地进行。在这个提议中，我们将讨论这样一个假设： 在妊娠早期开始的葡萄糖信号，将预测随后的GDM诊断， 与妊娠晚期诊断GDM相比，为了解决这个 假设，我们将使用CGM的数据来检查妊娠期间的血糖模式，并分析这些 模式，以确定它们与GDM后续发展的关联程度 对产妇和新生儿的不良影响 这项拟议的研究将确定无糖尿病妇女怀孕期间血糖水平的演变 糖尿病，并定义妊娠早期的妊娠模式，以确定将进展为GDM和/或 谁将更有可能有产妇和新生儿的不良后果。这些数据对于帮助 确定未来的临床试验和干预措施，以减少短期和长期不良妊娠结局。