Precision Prediction & Precision Medicine
In November 2019-2020 Riëlle Hoek-Hogchem did her 24-week internship at Diabeter. At the time she was a medical student from the Vrije Universiteit Amsterdam interested in Obstetrics, specifically in high-risk pregnancies. At Diabeter she worked on the GLYcaemic Variability in the Preconception Period in women with type 1 Diabetes on the occurrence of Pregnancy- and Perinatal complications (GLYVAP4) study as part of her graduation project. The results have now been published.
Pregnancy in women with type 1 diabetes is associated with higher complication risks, which can be reduced by optimal glycaemic control before and during pregnancy. It has been shown that perinatal and neonatal complications remain high despite adequate glycaemic control in women with type 1 diabetes. It is not yet known if and to what extent pre-conceptional glycaemic variability (GV) is associated with pregnancy- and perinatal complications.
The GLYVAP4 study assessesd if there is an association between pre-conception GV and pregnancy/perinatal maternal and neonatal complications. If so, GV could facilitate identification of high-risk pregnancies in women with type 1 Diabetes. Of 63 eligible women, 29 women (38 pregnancies) were included. Maternal and neonatal complications were summarized using a composite total complication score. Pre-/periconceptional GV and GV during all three trimesters was expressed as mean glucose, standard deviation (SD), Coefficient of Variation (CV), High Blood Glucose Index (HBGI), Low Blood Glucose Index (LBGI) and Average Daily Risk Range (ADRR).
Concluding, the authors state that