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 在过去的二十年中，妊娠糖尿病（GDM）的患病率大大增加。 鉴于GDM与不良妊娠结局的关联，这种增加的患病率也引起了人们的关注 作为妇女及其子女的长期不良结果。 GDM的识别和处理是 临床上重要的是，由于治疗可以减少至少（但不是全部）不良结果的频率。 GDM治疗与逆境的降低的不一致关系的一个潜在解释 母体，新生儿和童年的结果是GDM诊断和治疗通常发生在第三次 孕期，这可能为时已晚，无法改善与孕妇血糖相关的所有不良反应。 但是，努力在妊娠较早的妊娠中识别临床相关的母体性血糖，例如头三个月， 或预测谁将随后开发GDM，但没有成功。缺乏成功的原因之一 是怀孕期间的葡萄糖水平的评估主要涉及禁食的单数度量 葡萄糖或葡萄糖负荷后仅几个葡萄糖水平。这样的措施可能会提供有限的见解 在短期和长期的孕产妇血糖状态都处于通量状态。连续葡萄糖监测（CGM） 提供了评估葡萄糖概况的机会，并获得与这些配置文件如何变化有关的信息 在数小时，几天，几周和几个月中纵向。在此提案中，我们将解决以下假设 葡萄糖特征从怀孕初期开始，将预测GDM的随后诊断，并且会更好 与GDM的三年诊断相比，与孕产妇和新生儿结局有关。解决这个问题 假设，我们将使用CGM的数据检查怀孕期间的血糖模式，并分析这些模式 确定它们与随后的GDM发展有多大相关的模式 作为不良的母校和新生儿结果。 拟议的研究将定义没有糖尿病女性怀孕期间葡萄糖水平的演变 并定义了早期怀孕早期血糖的模式，这些妇女将升级为GDM和/或 谁会更有可能患有孕产妇和新生儿不良后果。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。