1254-P: Sensor Data in the Postprandial State—Impact of Macronutrients in Pregnant People with Diabetes

by sugaradmin



Introduction and Objective: Pregnancy changes maternal digestion and onset of insulin action. Continuous glucose monitoring (CGM) offers an opportunity to better understand the impact of meal content on postprandial glucose levels in pregnant people with diabetes.Methods: This sub-analysis of 18 participants in the Dexcom G7 pregnancy accuracy trial analyzed 2 hour postprandial CGM data from a 6 hour clinic session. Pregnant participants with pre-existing diabetes and gestational diabetes ate self-selected meals and snacks and continued usual diabetes care. All food ingested with >16g carbohydrates within 2 hours of meal start time were analyzed using the generalized estimating equations method to assess associations between CGM metrics and macronutrient content. Online nutritional information was used to estimate macronutrient content. This exploratory sub-analysis was not powered for statistical significance.Results: Time to peak glucose was 72.7 min (SD 38.2) with an earlier peak in the non-insulin group for higher %carbohydrate [Estimated Coefficient (EC) -1.26, 95% CI -1.56- -0.97] versus higher %fat (EC 0.77, 95% CI 0.11-1.42) and %protein (EC 0.85, 95% CI 0.18-1.53). Time to peak glucose for insulin treated participants showed a similar trend. Higher %carbohydrate resulted in a lower %pregnant specific time in range (PsTIR), (63-140mg/dl) for both insulin (EC -0.18, 95% CI-0.33- -0.03) and non-insulin (EC -0.42, 95% CI-1.26-0.43) treated participants while %fat (insulin EC 0.17, 95% CI-0.25-0.60; non-insulin EC 0.41, 95% CI-0.45-1.26) and %protein (insulin EC 0.36, 95% CI -1.08-1.79; non-insulin EC 0.10, 95% CI-0.14-0.35) had a positive association with PsTIR.Conclusion: CGM use further clarifies the relationship between nutritional macronutrients and glycemic changes in pregnant people with diabetes. Formal guidelines based on glycemic responses to food choices during pregnancy are needed.

Disclosure

C. Levister: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc. G. O’Malley: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc, Novo Nordisk, MannKind Corporation. P. Gao: Employee; Dexcom, Inc. X. Zhang: Employee; Dexcom, Inc. L. Yang: Employee; Dexcom, Inc. C.J. Levy: Research Support; Tandem Diabetes Care, Inc. Advisory Panel; Tandem Diabetes Care, Inc. Research Support; MannKind Corporation, Dexcom, Inc., Novo Nordisk, Eli Lilly and Company.

Funding

Dexcom



Source link