2022 Fiscal Year Final Research Report

The establishment of glycemic management in gestational diabetes mellitus: a new attempt to protect maternal and child health

Research Project

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Project/Area Number	20K10908
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 58070:Lifelong developmental nursing-related
Research Institution	Kyoto University
Principal Investigator	AZUMA Mayumi 京都大学, 医学研究科, 客員研究員 (20447981)
Co-Investigator(Kenkyū-buntansha)	古田真里枝京都大学, 医学研究科, 教授 (20390312) 西村亜希子香川大学, 医学部, 准教授 (70738674) 原島伸一京都大学, 医学研究科, 客員研究員 (80444793) 千草義継京都大学, 医学研究科, 助教 (80779158)
Project Period (FY)	2020-04-01 – 2023-03-31
Keywords	妊娠糖尿病 / 皮下連続式グルコース測定
Outline of Final Research Achievements	In this study, we were the first in the world to revealed blood glucose changes during each trimester of pregnancy and delivery in pregnant women with normal glucose tolerance (NGT) and pregnant women with gestational diabetes mellitus (GDM) using continuous glucose monitoring (CGM), and examined the association with perinatal complications. Pregnant women with NGT had lower preprandial, postprandial, nocturnal, and mean blood glucose than nonpregnant women, with no differences at each trimester of pregnancy. In GDM pregnant women who did not require insulin therapy, mean blood glucose was lower than that of nonpregnant women, but large for gestational ages (LGA) was born in cases of nocturnal blood glucose levels greater than 100 mg/dL. While, the risk of neonatal hypoglycemia was higher in cases with blood glucose levels exceeding 100 mg/dL continuously for 12 hours before delivery. To accumulate further evidence, this study is now being developed into an ongoing multicenter study.
Free Research Field	妊娠糖尿病
Academic Significance and Societal Importance of the Research Achievements	現在の妊娠各期と分娩期の血糖管理目標は非妊婦の正常血糖範囲を模した目標値となっており、エビデンスに乏しい。また現在の血糖管理目標では、目標範囲内に血糖管理が行われたにもかかわらず、新生児が低血糖をきたしたり在胎不当過大をきたしたりすることが明らかとなり、よりよい血糖管理目標の策定が世界的に急がれている。本研究では、CGMを用いて妊娠各期および分娩期の血糖変化を世界に先駆け明らかにした点と、GDM妊婦の血糖変化を連続測定することにより周産期合併症との関連を明らかにした点に学術的意義がある。妊娠期および分娩期の血糖管理目標の見直しに貢献し、より安全安心な出産管理に役立つ本研究の社会的意義は大きい。