{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:59:23Z","timestamp":1791392363644,"version":"4.3.3"},"reference-count":40,"publisher":"American Diabetes Association","issue":"3","license":[{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/100009881","name":"Juvenile Diabetes Research Foundation","doi-asserted-by":"publisher","award":["17-2011-533"],"award-info":[{"award-number":["17-2011-533"]}],"id":[{"id":"10.13039\/100009881","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009881","name":"Juvenile Diabetes Research Foundation","doi-asserted-by":"publisher","award":["80-2010-585"],"award-info":[{"award-number":["80-2010-585"]}],"id":[{"id":"10.13039\/100009881","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009881","name":"Juvenile Diabetes Research Foundation","doi-asserted-by":"publisher","award":["Sanofi-EFSD Innovative outcomes grant, 2017"],"award-info":[{"award-number":["Sanofi-EFSD Innovative outcomes grant, 2017"]}],"id":[{"id":"10.13039\/100009881","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000361","name":"Diabetes UK","doi-asserted-by":"publisher","award":["DUK-HKF 17\/0005712"],"award-info":[{"award-number":["DUK-HKF 17\/0005712"]}],"id":[{"id":"10.13039\/501100000361","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001648","name":"European Foundation for the Study of Diabetes","doi-asserted-by":"publisher","award":["EFSD-Novo Nordisk Foundation NNF19SA058974"],"award-info":[{"award-number":["EFSD-Novo Nordisk Foundation NNF19SA058974"]}],"id":[{"id":"10.13039\/501100001648","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["CDF-2013-06-035"],"award-info":[{"award-number":["CDF-2013-06-035"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The optimal method of monitoring glycemia in pregnant women with type 1 diabetes remains controversial. This study aimed to assess the predictive performance of HbA1c, continuous glucose monitoring (CGM) metrics, and alternative biochemical markers of glycemia to predict obstetric and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>One hundred fifty-seven women from the Continuous Glucose Monitoring in Women With Type 1 Diabetes in Pregnancy Trial (CONCEPTT) were included in this prespecified secondary analysis. HbA1c, CGM data, and alternative biochemical markers (glycated CD59, 1,5-anhydroglucitol, fructosamine, glycated albumin) were compared at \u223c12, 24, and 34 weeks\u2019 gestation using logistic regression and receiver operating characteristic (ROC) curves to predict pregnancy complications (preeclampsia, preterm delivery, large for gestational age, neonatal hypoglycemia, admission to neonatal intensive care unit).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>HbA1c, CGM metrics, and alternative laboratory markers were all significantly associated with obstetric and neonatal outcomes at 24 weeks\u2019 gestation. More outcomes were associated with CGM metrics during the first trimester and with laboratory markers (area under the ROC curve generally &amp;lt;0.7) during the third trimester. Time in range (TIR) (63\u2013140 mg\/dL [3.5\u20137.8 mmol\/L]) and time above range (TAR) (&amp;gt;140 mg\/dL [&amp;gt;7.8 mmol\/L]) were the most consistently predictive CGM metrics. HbA1c was also a consistent predictor of suboptimal pregnancy outcomes. Some alternative laboratory markers showed promise, but overall, they had lower predictive ability than HbA1c.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>HbA1c is still an important biomarker for obstetric and neonatal outcomes in type 1 diabetes pregnancy. Alternative biochemical markers of glycemia and other CGM metrics did not substantially increase the prediction of pregnancy outcomes compared with widely available HbA1c and increasingly available CGM metrics (TIR and TAR).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc20-2360","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T17:35:28Z","timestamp":1611596128000},"page":"681-689","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":53,"title":["Novel Biochemical Markers of Glycemia to Predict Pregnancy Outcomes in Women With Type 1 Diabetes"],"prefix":"10.2337","volume":"44","clinical-trial-number":[{"clinical-trial-number":"nct01788527","registry":"10.18810\/clinical-trials-gov","type":"results"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4176-8329","authenticated-orcid":false,"given":"Claire L.","family":"Meek","sequence":"first","affiliation":[{"name":"Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, U.K."},{"name":"Cambridge Universities NHS Foundation Trust, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Tundidor","sequence":"additional","affiliation":[{"name":"Institut de Recerca de l\u2019Hospital de la Santa Creu i Sant Pau, Barcelona, Spain"},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denice S.","family":"Feig","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital, Sinai Health System, Department of Medicine, University of Toronto, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"},{"name":"Department of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5395-8261","authenticated-orcid":false,"given":"Eleanor M.","family":"Scott","sequence":"additional","affiliation":[{"name":"Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Centre for Diabetes and Endocrinology, University of Leeds, Leeds, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane D.","family":"Ma","sequence":"additional","affiliation":[{"name":"Laboratory for Translational Research, Harvard Medical School, Brigham and Women\u2019s Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Halperin","sequence":"additional","affiliation":[{"name":"Laboratory for Translational Research, Harvard Medical School, Brigham and Women\u2019s Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6876-8727","authenticated-orcid":false,"given":"Helen R.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich, U.K."},{"name":"School of Life Course Sciences, King\u2019s College London, London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5055-6814","authenticated-orcid":false,"given":"Rosa","family":"Corcoy","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"},{"name":"Servei d\u2019Endocrinologia i Nutrici\u00f3, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain"},{"name":"Centros de Investigaci\u00f3n Biom\u00e9dica en Red en Bioingenier\u00eda, Biomateriales y Nanomedicina, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2021,2,11]]},"reference":[{"key":"2022031309353938900_B1","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1007\/s00125-017-4314-3","article-title":"Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study","volume":"60","author":"Murphy","year":"2017","journal-title":"Diabetologia"},{"key":"2022031309353938900_B2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.3109\/14767058.2013.806896","article-title":"Poor pregnancy outcome in women with type 1 diabetes is predicted by elevated HbA1c and spikes of high glucose values in the third trimester","volume":"27","author":"Damm","year":"2014","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2022031309353938900_B3","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.jdiacomp.2007.03.008","article-title":"Elevated third-trimester haemoglobin A 1c predicts preterm delivery in type 1 diabetes","volume":"22","author":"Ekbom","year":"2008","journal-title":"J Diabetes Complications"},{"key":"2022031309353938900_B4","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1007\/s00125-017-4205-7","article-title":"Translating HbA1c measurements into estimated average glucose values in pregnant women with diabetes","volume":"60","author":"Law","year":"2017","journal-title":"Diabetologia"},{"key":"2022031309353938900_B5","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1177\/1932296815572255","article-title":"Physiologic concepts that may revise the interpretation and implications of HbA1C in clinical medicine: an American perspective","volume":"9","author":"Smith","year":"2015","journal-title":"J Diabetes Sci Technol"},{"key":"2022031309353938900_B6","doi-asserted-by":"crossref","first-page":"E999","DOI":"10.1210\/jc.2013-4232","article-title":"Glycation of the complement regulatory protein CD59 is a novel biomarker for glucose handling in humans","volume":"99","author":"Ghosh","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"2022031309353938900_B7","doi-asserted-by":"crossref","first-page":"725","DOI":"10.4158\/EP14437.OR","article-title":"1,5-Anhydroglucitol and neonatal complications in pregnancy complicated by diabetes","volume":"21","author":"Wright","year":"2015","journal-title":"Endocr Pract"},{"key":"2022031309353938900_B8","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.pedneo.2016.02.003","article-title":"Complications in infants of diabetic mothers related to glycated albumin and hemoglobin levels during pregnancy","volume":"57","author":"Sugawara","year":"2016","journal-title":"Pediatr Neonatol"},{"key":"2022031309353938900_B9","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1016\/S0140-6736(17)32400-5","article-title":"Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial","volume":"390","author":"Feig","year":"2017","journal-title":"Lancet"},{"key":"2022031309353938900_B10","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1007\/s00125-019-4850-0","article-title":"Continuous glucose monitoring in pregnant women with type 1 diabetes: an observational cohort study of 186 pregnancies","volume":"62","author":"Kristensen","year":"2019","journal-title":"Diabetologia"},{"key":"2022031309353938900_B11","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.2337\/dc19-2527","article-title":"Continuous glucose monitoring in pregnancy: importance of analyzing temporal profiles to understand clinical outcomes","volume":"43","author":"Scott","year":"2020","journal-title":"Diabetes Care"},{"key":"2022031309353938900_B12","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1002\/ajh.23478","article-title":"A specific and sensitive assay for blood levels of glycated CD59: a novel biomarker for diabetes","volume":"88","author":"Ghosh","year":"2013","journal-title":"Am J Hematol"},{"key":"2022031309353938900_B13","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.2337\/dci19-0028","article-title":"Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range","volume":"42","author":"Battelino","year":"2019","journal-title":"Diabetes Care"},{"key":"2022031309353938900_B14","doi-asserted-by":"crossref","first-page":"509","DOI":"10.2337\/dc09-1954","article-title":"A1C but not serum glycated albumin is elevated because of iron deficiency in late pregnancy in diabetic women","volume":"33","author":"Hashimoto","year":"2010","journal-title":"Diabetes Care"},{"key":"2022031309353938900_B15","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/S2213-8587(13)70199-2","article-title":"Fructosamine and glycated albumin for risk stratification and prediction of incident diabetes and microvascular complications: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study","volume":"2","author":"Selvin","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2022031309353938900_B16","doi-asserted-by":"crossref","first-page":"960","DOI":"10.2337\/dc10-1945","article-title":"Nontraditional markers of glycemia: associations with microvascular conditions","volume":"34","author":"Selvin","year":"2011","journal-title":"Diabetes Care"},{"key":"2022031309353938900_B17","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1097\/00029330-200611020-00003","article-title":"Value of fructosamine measurement in pregnant women with abnormal glucose tolerance","volume":"119","author":"Li","year":"2006","journal-title":"Chin Med J (Engl)"},{"key":"2022031309353938900_B18","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1016\/S0140-6736(83)90982-0","article-title":"Fructosamine in diabetic pregnancy","volume":"2","author":"Roberts","year":"1983","journal-title":"Lancet"},{"key":"2022031309353938900_B19","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/0028-2243(91)90295-V","article-title":"Serum fructosamine is not a useful screening test for gestational diabetes","volume":"38","author":"Corcoy","year":"1991","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2022031309353938900_B20","first-page":"151","article-title":"Markers of glycemic control and neonatal morbidity in high-risk insulin-resistant pregnancies","volume":"33","author":"Cahill","year":"2016","journal-title":"Am J Perinatol"},{"key":"2022031309353938900_B21","doi-asserted-by":"crossref","first-page":"863","DOI":"10.3109\/00365519209088392","article-title":"Blood glycated haemoglobin, serum fructosamine, serum glycated albumin and serum glycated total protein as measures of glycaemia in diabetes mellitus","volume":"52","author":"Koskinen","year":"1992","journal-title":"Scand J Clin Lab Invest"},{"key":"2022031309353938900_B22","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1016\/j.cca.2012.04.025","article-title":"Glycated albumin in diabetic patients with chronic kidney disease","volume":"413","author":"Zheng","year":"2012","journal-title":"Clin Chim Acta"},{"key":"2022031309353938900_B23","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1586\/14737159.8.1.9","article-title":"1,5-anhydroglucitol (GlycoMark) as a marker of short-term glycemic control and glycemic excursions","volume":"8","author":"Dungan","year":"2008","journal-title":"Expert Rev Mol Diagn"},{"key":"2022031309353938900_B24","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.ejogrb.2015.03.021","article-title":"1,5-Anhydroglucitol: a new predictor of neonatal birth weight in diabetic pregnancies","volume":"189","author":"Delaney","year":"2015","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2022031309353938900_B25","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/s00125-013-2830-3","article-title":"1,5-Anhydroglucitol as a marker of maternal glycaemic control and predictor of neonatal birthweight in pregnancies complicated by type 1 diabetes mellitus","volume":"56","author":"Nowak","year":"2013","journal-title":"Diabetologia"},{"key":"2022031309353938900_B26","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.2337\/dc17-0391","article-title":"The association of falling insulin requirements with maternal biomarkers and placental dysfunction: a prospective study of women with preexisting diabetes in pregnancy","volume":"40","author":"Padmanabhan","year":"2017","journal-title":"Diabetes Care"},{"key":"2022031309353938900_B27","doi-asserted-by":"crossref","first-page":"5450","DOI":"10.1073\/pnas.97.10.5450","article-title":"Molecular basis for a link between complement and the vascular complications of diabetes","volume":"97","author":"Acosta","year":"2000","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2022031309353938900_B28","doi-asserted-by":"crossref","first-page":"2653","DOI":"10.2337\/diabetes.53.10.2653","article-title":"Glycation inactivation of the complement regulatory protein CD59: a possible role in the pathogenesis of the vascular complications of human diabetes","volume":"53","author":"Qin","year":"2004","journal-title":"Diabetes"},{"key":"2022031309353938900_B29","doi-asserted-by":"crossref","first-page":"e1033","DOI":"10.1210\/clinem\/dgaa087","article-title":"Plasma glycated CD59 predicts early gestational diabetes and large for gestational age newborns","volume":"105","author":"Ma","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2022031309353938900_B30","doi-asserted-by":"crossref","first-page":"697","DOI":"10.3389\/fendo.2019.00697","article-title":"Application and utility of continuous glucose monitoring in pregnancy: a systematic review","volume":"10","author":"Yu","year":"2019","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2022031309353938900_B31","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1089\/dia.2017.0443","article-title":"Continuous glucose monitoring, glycemic variability, and excessive fetal growth in pregnancies complicated by type 1 diabetes","volume":"20","author":"Mulla","year":"2018","journal-title":"Diabetes Technol Ther"},{"key":"2022031309353938900_B32","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1177\/1932296817752374","article-title":"Correlation between third trimester glycemic variability in non-insulin-dependent gestational diabetes mellitus and adverse pregnancy and fetal outcomes","volume":"12","author":"Panyakat","year":"2018","journal-title":"J Diabetes Sci Technol"},{"key":"2022031309353938900_B33","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1089\/dia.2010.0145","article-title":"Glucose variability in diabetic pregnancy","volume":"13","author":"Dalfr\u00e0","year":"2011","journal-title":"Diabetes Technol Ther"},{"key":"2022031309353938900_B34","doi-asserted-by":"crossref","first-page":"810","DOI":"10.2337\/dc18-2212","article-title":"Suboptimal nocturnal glucose control is associated with large for gestational age in treated gestational diabetes mellitus","volume":"42","author":"Law","year":"2019","journal-title":"Diabetes Care"},{"key":"2022031309353938900_B35","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.2337\/dc15-0070","article-title":"Analysis of continuous glucose monitoring in pregnant women with diabetes: distinct temporal patterns of glucose associated with large-for-gestational-age infants","volume":"38","author":"Law","year":"2015","journal-title":"Diabetes Care"},{"key":"2022031309353938900_B36","doi-asserted-by":"crossref","first-page":"400","DOI":"10.2337\/dc18-1444","article-title":"Validation of time in range as an outcome measure for diabetes clinical trials","volume":"42","author":"Beck","year":"2019","journal-title":"Diabetes Care"},{"key":"2022031309353938900_B37","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1007\/s00125-019-05027-0","article-title":"Positioning time in range in diabetes management","volume":"63","author":"Advani","year":"2020","journal-title":"Diabetologia"},{"key":"2022031309353938900_B38","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.2337\/dc11-0244","article-title":"Optimal glycemic control, pre-eclampsia, and gestational hypertension in women with type 1 diabetes in the diabetes and pre-eclampsia intervention trial","volume":"34","author":"Holmes","year":"2011","journal-title":"Diabetes Care"},{"key":"2022031309353938900_B39","article-title":"First trimester preeclampsia screening and prediction","author":"Chaemsaithong","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"2022031309353938900_B40","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1007\/s00125-019-4904-3","article-title":"Continuous glucose monitoring targets in type 1 diabetes pregnancy: every 5% time in range matters","volume":"62","author":"Murphy","year":"2019","journal-title":"Diabetologia"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/care.diabetesjournals.org\/syndication\/doi\/10.2337\/dc20-2360","content-type":"unspecified","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/44\/3\/681\/631909\/dc202360.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/44\/3\/681\/631909\/dc202360.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T06:47:31Z","timestamp":1647154051000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/44\/3\/681\/138543\/Novel-Biochemical-Markers-of-Glycemia-to-Predict"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,11]]},"references-count":40,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,2,11]]},"published-print":{"date-parts":[[2021,3,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc20-2360","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,11]]}}}