Background and Aims
Elevated maternal triglycerides are associated with adverse pregnancy outcomes including an increased risk of preeclampsia and macrosomia. Maternal triglycerides are usually measured in the fasting state and at a single time point during pregnancy. It is known that glucose “flux” is important, but it is not known if and how maternal triglycerides change throughout the day in the home setting. The purpose of these investigations was to examine the feasibility of home monitoring of triglycerides, the daily fluctuations in triglycerides and how triglyceride levels are influenced by high and low fat meals.
Materials and methods
A series of studies have been undertaken. The Roche Accutrend Plus meter with triglyceride strips was validated for use in late pregnancy1. Maternal capillary triglycerides were then examined in the home setting for 4-6 days in the third trimester (4 times a day (fasting and two hours post meals))2. Lastly, a home based mixed breakfast meal test was performed using isocaloric high fat (58%) and low fat (10%) meals on alternate days. Women consumed their normal diet around the meal tests.
Results
Home monitoring was found to be feasible, although requiring education in meter use and phone support. In the meal test, thirteen women, 7 with GDM and 6 normoglycaemic completed the study. Median capillary triglycerides were: fasting 3.3 (95%CI 2.9-3.8) mmol/L, postprandial 3.6 (95%CI 3.2-3.8) mmol/L. There was no significant difference in AUC capillary triglycerides between the meals. There was no influence of GDM status on AUC triglycerides for either meal.
Conclusion
These studies demonstrated capillary triglycerides can be monitored at home in a similar fashion to capillary glucose. There was a trend to higher capillary glucose with low fat meal, but no significant differences in triglycerides. This may be due to limited/small sample size which is being further increased.