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ADA Member Advantage ends Chase endorsement for credit card processing

ADA Member Advantage announced April 1 it ended its endorsement relationship with Chase for credit card processing.




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ADA offers free e-books on professional risk, OSHA from April 1-7

As part of its ongoing efforts to support dentists during the COVID-19 pandemic, the ADA is offering members two free e-books the week of April 1-7: “Managing Professional Risks: Best Practices” and “The ADA Practical Guide to OSHA Training: Compliance for Dental Professionals.”




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ADA releases interim guidance on minimizing COVID-19 transmission risk when treating dental emergencies

The American Dental Association has released interim guidance for dentists on how to minimize the risk of COVID-19 transmission before, during and after treating dental emergencies.




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Kansas City University names Dr. Linda C. Niessen as dental school founding dean

Kansas City University announced March 30 that it named Dr. Linda C. Niessen as its founding dean of the KCU College of Dental Medicine, which is slated to open in fall 2022 on its Joplin, Missouri, campus.




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ADA asks Treasury Department, Small Business Administration to clarify intent of interim rule

The Association continues to wait for clear guidance from the U.S. Department of Treasury and Small Business Administration on the best way to help dentists considering applying for Paycheck Protection Program 7(a) loans and Economic Injury Disaster Loans.




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Small Business Administration: Dentists can apply for both economic injury disaster and paycheck protection program loans

Dentists can apply for both Economic Injury Disaster Loans and Paycheck Protection Program 7(a) loans, the Small Business Administration told the American Dental Association on April 6.




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10 Under 10 Awards: Recognizing the ‘unsung heroes’ of the profession

The ADA announced April 6 the recipients of its third annual 10 Under 10 Awards, which recognizes 10 new dentists who demonstrate excellence early in their careers.




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OCR warns of imposter posing as investigator

Washington — The Office for Civil Rights released a statement April 3 warning of an individual posing as an OCR investigator. The imposter has been calling entities covered by the Health Insurance Portability and Accountability Act of 1996 in an attempt to get patient information.




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CODA site visits rescheduled to 2021 due to COVID-19

The Commission on Dental Accreditation announced April 3 that it will reschedule all postponed and remaining site visits this year, including regular/reaccreditation and special focused site visits, to 2021 in response to the COVID-19 pandemic.




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ADA leadership answers members’ questions about minimizing risk of COVID-19 transmission

A panel of ADA experts answered members’ questions in a video released April 8 regarding the Association’s interim guidance for minimizing the risk of COVID-19 transmission while performing emergency and urgent dental care.




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Webinar on Small Business Administration loans available online

The ADA webinar, Small Business Administration Loans: Understanding the Options for Dentist Owners, is available online.




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ADA asks Congress to increase funding, extend dates for Small Business Administration loans

The ADA is urging Congress to continue supporting small businesses during the COVID-19 pandemic by increasing funding and streamlining the application process for Small Business Administration loans.




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Homeland Security issues alert on cybercriminals increasingly exploiting COVID-19 pandemic

The U.S. Department of Homeland Security issued an alert April 8 warning that cybercriminals are increasingly exploiting the COVID-19 pandemic to target individuals, small and medium businesses and large organizations.




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ADA president appoints task force for dental practice recovery after COVID-19 pandemic

American Dental Association President Chad P. Gehani has assembled an advisory task force to oversee the ADA’s development of tools for dentists as they bounce back from the effects of practice restrictions and closures caused by the COVID-19 pandemic.




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ADA president: ‘This will pass’

“Dentistry is very resilient to any obstacles put in front of the profession. It’s a great profession and if I have to do it over again, I would again want to be a dentist.” Those were the words of ADA President Chad P. Gehani in a candid interview about the Association’s response to the COVID-19 pandemic.




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Index shows that dentists slowly but surely embracing electronic means of doing business

Despite the ADA Council on Dental Benefits’ efforts, the practice of using automated electronic means for verifying eligibility and benefits, checking claim status or receiving and reconciling payment remains underutilized by many dental providers according to an index, said Dr. Randall Markarian, council chair.




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Wisconsin dentists donate personal protective equipment amid COVID-19 pandemic

Wisconsin dentists have answered the call for personal protective equipment by organizing drives and donating their surplus supplies to hospitals and urgent care facilities treating patients with COVID-19.




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ADA offers interim guidance as some states consider reopening

“To aid dentists who may be reopening their practices when state mandates are lifted,” the ADA issued an updated statement and interim guidance April 18 on the personal protective equipment recommended in order to practice during this pandemic and minimize the risk of virus transmission.




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Senate votes to expand small business aid

The Senate passed new coronavirus relief legislation April 21 calling for much-needed funding for depleted federal loan programs that could help businesses nationwide, including dentists and dental practices, recover from the economic fallout of the pandemic.




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American College of Emergency Physicians endorses ADA's antibiotics guideline

The American College of Emergency Physicians has endorsed the American Dental Association's clinical practice guideline on the use of antibiotics for the management of pulpal- and periapical-related pain and swelling.




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ADA advocates that third-party payers modify fee schedules as dentists consider going back to work

The ADA is urging third-party payers to alter their fees to account for the increasing cost of personal protective equipment that dentists are using to protect themselves, their staff and patients.




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ADA president: Reopening dental practices needs a team approach

As some dental practices begin plans to reopen and provide nonemergency care — as some states reopen following the direction of their state — the Association is urging dentists to have robust communication and engage their dental team members to address any concerns related to returning to work amid the COVID-19 pandemic.




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Dental materials research 'icon' who developed Bis-GMA resin dies

Dr. Rafael "Ray" Bowen, who made significant contributions to dental materials research and retired in 2018 after 62 years at the American Dental Association, has died.




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ADA Member Advantage endorses Best Card for credit card processing

ADA Member Advantage announced May 1 that it has selected Best Card as its exclusively endorsed credit card processing solution for Association members.




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Department of Labor releases Pandemic Unemployment Assistance FAQ

The Department of Labor released an FAQ April 27 that addresses common questions about work search and job refusal when an individual receives Pandemic Unemployment Assistance.




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U.S. fuel pumps see first weekly price rise since October

Fuel prices in the United States on average were just a penny higher at $2.25 per gallon, ending consecutive price declines that had occurred since October.




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Petrobras preempts three pre-salt areas ahead of sixth auction

Petrobras wants to exercise pre-emption rights for three areas ahead of the sixth bidding round of pre-salt offshore oil areas to be held later this year.




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Crude prices rise after positive news from China

Oil prices rose early Tuesday, after Monday declines, possibly helped by some positive news from China -- but doubts remain as to whether that direction will hold.




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Oil prices led lower by rising U.S. production, inventories

Oil prices fell early Thursday despite an OPEC report confirming a sizable cut due to bearishness related to rising United States production and inventories.




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IEA doubts Russia’s commitment to OPEC accord

The Paris-based International Energy Agency on Friday cast doubt on whether Russia would meet its agreement with OPEC to cut crude oil output to support prices.




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Oil rises after report on possible China talks concessions

Oil prices rose early Friday trailing equity gains late Thursday that followed a report about possible concessions ahead in U.S. trade talks with China.




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Refineries, investors fear crude shortages over possible Venezuela sanctions

An unexpected rise in U.S. crude inventories offset fears of potential risk to Venezuelan crude supply because of possible U.S. sanctions.




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Oil prices fall on rising U.S. rigs, fading Venezuelan risk

Oil prices fell Monday as the number of rigs in the United States saw a weekly rise, analysts said




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IEA: Greater use of rail would save energy, lower emissions

Increased railway use would save energy, help the environment, and also be safer, according to reports prepared by international environmental experts.




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Oil nearly flat in pause after previous session's gains

Oil prices were near flat early Thursday in what was seen as a pause after gains in the two previous sessions, as traders considered geopolitical developments.




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Poverty, lack of insurance can make heart failure prognosis worse, AHA says

Poverty and poor or non-existent health insurance coverage might worsen the effects of heart failure, the American Heart Association said Thursday.




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Blood clots, skin lesions among newly identified possible COVID-19 symptoms

Blood clots, skin rashes and other lesions might be among the symptoms some people experience with COVID-19, according to new research released Thursday.




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Suicide risk high in first year after brain cancer diagnosis

People with brain cancer are at increased risk for suicide compared to the general population, particularly within the first year following diagnosis, a new analysis has found.




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CDC: Nearly 5,000 workers at meat processing plants diagnosed with COVID-19

Nearly 5,000 workers in 115 meat processing workers across 19 states have been diagnosed with COVID-19, according to figures released Friday by the U.S. Centers for Disease Control and Prevention.




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FDA approves remdesivir to treat COVID-19

The U.S. Food and Drug Administration on Friday granted emergency use authorization to the antiviral remdesivir to treat COVID-19.




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Analysis suggests states need to plan for second wave of COVID-19

Leaders across the United States should plan for a worst-case scenario, second wave to the COVID-19 pandemic, including no vaccine availability or herd immunity, say experts at the University of Minnesota.




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U.S. ICUs could still be overwhelmed by COVID-19 patients, analysis says

Communities across the U.S. still need to expand hospital capacity to manage new COVID-19 cases, even as some states loosen social distancing restrictions, a study published Wednesday by JAMA Network Open says.




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Measles vaccinations in U.S. children fall up to 60 percent since pandemic, CDC says

Pediatric vaccination against measles has declined by as much as 60 percent nationally since the start of the COVID-19 outbreak, according to new data released Friday by the Centers for Disease Control and Prevention.




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Social Innovation for Refugee Inclusion: From Bright Spots to System Change

In the three years since the European migration and refugee crisis vividly captured public attention, a wave of innovative initiatives has emerged to help newcomers settle into receiving societies. Now, as the sense of crisis abates, this report explores what these initiatives will need to do to outlast the hype and produce lasting change on key integration issues such as housing, economic inclusion, and community building.




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Trends in Uninsured Rates Before and After Medicaid Expansion in Counties Within and Outside of the Diabetes Belt

OBJECTIVE

To examine trends in uninsured rates between 2012 and 2016 among low-income adults aged <65 years and to determine whether the Patient Protection and Affordable Care Act (ACA), which expanded Medicaid, impacted insurance coverage in the Diabetes Belt, a region across 15 southern and eastern states in which residents have high rates of diabetes.

RESEARCH DESIGN AND METHODS

Data for 3,129 U.S. counties, obtained from the Small Area Health Insurance Estimates and Area Health Resources Files, were used to analyze trends in uninsured rates among populations with a household income ≤138% of the federal poverty level. Multivariable analysis adjusted for the percentage of county populations aged 50–64 years, the percentage of women, Distressed Communities Index value, and rurality.

RESULTS

In 2012, 39% of the population in the Diabetes Belt and 34% in non-Belt counties were uninsured (P < 0.001). In 2016 in states where Medicaid was expanded, uninsured rates declined rapidly to 13% in Diabetes Belt counties and to 15% in non-Belt counties. Adjusting for county demographic and economic factors, Medicaid expansion helped reduce uninsured rates by 12.3% in Diabetes Belt counties and by 4.9% in non-Belt counties. In 2016, uninsured rates were 15% higher for both Diabetes Belt and non-Belt counties in the nonexpansion states than in the expansion states.

CONCLUSIONS

ACA-driven Medicaid expansion was more significantly associated with reduced uninsured rates in Diabetes Belt than in non-Belt counties. Initial disparities in uninsured rates between Diabetes Belt and non-Belt counties have not existed since 2014 among expansion states. Future studies should examine whether and how Medicaid expansion may have contributed to an increase in the use of health services in order to prevent and treat diabetes in the Diabetes Belt.




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Rapid Corneal Nerve Fiber Loss: A Marker of Diabetic Neuropathy Onset and Progression

OBJECTIVE

Corneal nerve fiber length (CNFL) represents a biomarker for diabetic distal symmetric polyneuropathy (DSP). We aimed to determine the reference distribution of annual CNFL change, the prevalence of abnormal change in diabetes, and its associated clinical variables.

RESEARCH DESIGN AND METHODS

We examined 590 participants with diabetes [399 type 1 diabetes (T1D) and 191 type 2 diabetes (T2D)] and 204 control patients without diabetes with at least 1 year of follow-up and classified them according to rapid corneal nerve fiber loss (RCNFL) if CNFL change was below the fifth percentile of the control patients without diabetes.

RESULTS

Control patients without diabetes were 37.9 ± 19.8 years old, had median follow-up of three visits over 3.0 years, and mean annual change in CNFL was –0.1% (90% CI, –5.9 to 5.0%). RCNFL was defined by values exceeding the fifth percentile of 6% loss. Participants with T1D were 39.9 ± 18.7 years old, had median follow-up of three visits over 4.4 years, and mean annual change in CNFL was –0.8% (90% CI, –14.0 to 9.9%). Participants with T2D were 60.4 ± 8.2 years old, had median follow-up of three visits over 5.3 years, and mean annual change in CNFL was –0.2% (90% CI, –14.1 to 14.3%). RCNFL prevalence was 17% overall and was similar by diabetes type [64 T1D (16.0%), 37 T2D (19.4%), P = 0.31]. RNCFL was more common in those with baseline DSP (47% vs. 30% in those without baseline DSP, P = 0.001), which was associated with lower peroneal conduction velocity but not with baseline HbA1c or its change over follow-up.

CONCLUSIONS

An abnormally rapid loss of CNFL of 6% per year or more occurs in 17% of diabetes patients. RCNFL may identify patients at highest risk for the development and progression of DSP.




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Performance of High-Sensitivity Cardiac Troponin Assays To Reflect Comorbidity Burden and Improve Mortality Risk Stratification in Older Adults With Diabetes

OBJECTIVE

Incorporation of comorbidity burden to inform diabetes management in older adults remains challenging. High-sensitivity cardiac troponins are objective, quantifiable biomarkers that may improve risk monitoring in older adults. We assessed the associations of elevations in high-sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT) with comorbidities and improvements in mortality risk stratification.

RESEARCH DESIGN AND METHODS

We used logistic regression to examine associations of comorbidities with elevations in either troponin (≥85th percentile) among 1,835 participants in the Atherosclerosis Risk in Communities (ARIC) Study with diabetes (ages 67–89 years, 43% male, 31% black) at visit 5 (2011–2013). We used Cox models to compare associations of high cardiac troponins with mortality across comorbidity levels.

RESULTS

Elevations in either troponin (≥9.4 ng/L for hs-cTnI, ≥25 ng/L for hs-cTnT) were associated with prevalent coronary heart disease, heart failure, chronic kidney disease, pulmonary disease, hypoglycemia, hypertension, dementia, and frailty. Over a median follow-up of 6.2 years (418 deaths), both high hs-cTnI and high hs-cTnT further stratified mortality risk beyond comorbidity levels; those with a high hs-cTnI or hs-cTnT and high comorbidity were at highest mortality risk. Even among those with low comorbidity, a high hs-cTnI (hazard ratio [HR] 3.0 [95% CI 1.7, 5.4]) or hs-cTnT (HR 3.3 [95% CI 1.8, 6.2]) was associated with elevated mortality.

CONCLUSIONS

Many comorbidities were reflected by both hs-cTnI and hs-cTnT; elevations in either of the troponins were associated with higher mortality risk beyond comorbidity burden. High-sensitivity cardiac troponins may identify older adults at high mortality risk and be useful in guiding clinical care of older adults with diabetes.




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Reduced Myocardial Perfusion Reserve in Type 2 Diabetes Is Caused by Increased Perfusion at Rest and Decreased Maximal Perfusion During Stress

OBJECTIVE

To examine differences in myocardial blood flow (MBF) at rest and during stress between patients with type 2 diabetes and controls, and to identify potential predictors of changes in MBF at rest and during stress.

RESEARCH DESIGN AND METHODS

A cross-sectional study of 193 patients with type 2 diabetes and 20 age- and sex-matched controls. Cardiovascular magnetic resonance was used in order to evaluate left ventricular structure and function, and MBF at rest and during adenosine-induced stress. MBF was derived as the mean of the flow within all segments of a midventricular slice.

RESULTS

Patients with type 2 diabetes had higher global MBF at rest (0.81 ± 0.19 mL/min/g) and lower global MBF during stress (2.4 ± 0.9 mL/min/g) than did controls (0.61 ± 0.11 at rest, 3.2 ± 0.8 mL/min/g under stress; both P < 0.01). Patients with macroalbuminuria had lower MBF during stress (1.6 ± 0.5 mL/min/g) than did patients with microalbuminuria (2.1 ± 0.7 mL/min/g; P = 0.04), who in turn had lower MBF during stress than did normoalbuminuric patients (2.7 ± 0.9 mL/min/g; P < 0.01). Patients with severe retinopathy had lower MBF during stress (1.8 ± 0.6 mL/min/g) than did patients with simplex retinopathy (2.3 ± 0.7 mL/min/g; P < 0.05) and those who did not have retinopathy (2.6 ± 1.0 mL/min/g; P < 0.05). Albuminuria and retinopathy were associated with reduced MBF during stress in a multiple regression analysis. Stress-related MBF inversely correlated with myocardial extracellular volume (P < 0.001; R2 = 0.37), a measure of diffuse myocardial fibrosis. A trend toward lower basal MBF was observed in patients treated with sodium–glucose cotransporter 2 inhibitors (P = 0.07).

CONCLUSIONS

Patients with type 2 diabetes have higher global MBF at rest and lower maximal MBF during vasodilator-induced stress than do controls. Reduced MBF during stress is associated with diabetes complications (albuminuria and retinopathy) and is inversely correlated with diffuse myocardial fibrosis.




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The Effects of Intensive Glycemic Control on Clinical Outcomes Among Patients With Type 2 Diabetes With Different Levels of Cardiovascular Risk and Hemoglobin A1c in the ADVANCE Trial

OBJECTIVE

To study whether the effects of intensive glycemic control on major vascular outcomes (a composite of major macrovascular and major microvascular events), all-cause mortality, and severe hypoglycemia events differ among participants with different levels of 10-year risk of atherosclerotic cardiovascular disease (ASCVD) and hemoglobin A1c (HbA1c) at baseline.

RESEARCH DESIGN AND METHODS

We studied the effects of more intensive glycemic control in 11,071 patients with type 2 diabetes (T2D), without missing values, in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial, using Cox models.

RESULTS

During 5 years’ follow-up, intensive glycemic control reduced major vascular events (hazard ratio [HR] 0.90 [95% CI 0.83–0.98]), with the major driver being a reduction in the development of macroalbuminuria. There was no evidence of differences in the effect, regardless of baseline ASCVD risk or HbA1c level (P for interaction = 0.29 and 0.94, respectively). Similarly, the beneficial effects of intensive glycemic control on all-cause mortality were not significantly different across baseline ASCVD risk (P = 0.15) or HbA1c levels (P = 0.87). The risks of severe hypoglycemic events were higher in the intensive glycemic control group compared with the standard glycemic control group (HR 1.85 [1.41–2.42]), with no significant heterogeneity across subgroups defined by ASCVD risk or HbA1c at baseline (P = 0.09 and 0.18, respectively).

CONCLUSIONS

The major benefits for patients with T2D in ADVANCE did not substantially differ across levels of baseline ASCVD risk and HbA1c.




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Continuous Glucose Monitoring in Pregnancy: Importance of Analysing Temporal Profiles to Understand Clinical Outcomes

OBJECTIVE

To determine if temporal glucose profiles differed between 1) women who were randomized to real-time continuous glucose monitoring (RT-CGM) or self-monitored blood glucose (SMBG), 2) women who used insulin pumps or multiple daily insulin injections (MDIs), and 3) women whose infants were born large for gestational age (LGA) or not, by assessing CGM data obtained from the Continuous Glucose Monitoring in Women With Type 1 Diabetes in Pregnancy Trial (CONCEPTT).

RESEARCH DESIGN AND METHODS

Standard summary metrics and functional data analysis (FDA) were applied to CGM data from the CONCEPTT trial (RT-CGM, n = 100; SMBG, n = 100) taken at baseline and at 24- and 34-weeks gestation. Multivariable regression analysis determined if temporal differences in 24-h glucose profiles occurred between comparators in each of the three groups.

RESULTS

FDA revealed that women using RT-CGM had significantly lower glucose (0.4–0.8 mmol/L [7–14 mg/dL]) for 7 h/day (0800 h–1200 h and 1600 h–1900 h) compared with those with SMBG. Women using pumps had significantly higher glucose (0.4–0.9 mmol/L [7–16 mg/dL]) for 12 h/day (0300 h to 0600 h, 1300 h to 1800 h, and 2030 h to 0030 h) at 24 weeks with no difference at 34 weeks compared with MDI. Women who had an LGA infant ran a significantly higher glucose by 0.4–0.7 mmol/L (7–13 mg/dL) for 4.5 h/day at baseline; by 0.4–0.9 mmol/L (7–16 mg/dL) for 16 h/day at 24 weeks; and by 0.4–0.7 mmol/L (7–13 mg/dL) for 14 h/day at 34 weeks.

CONCLUSIONS

FDA of temporal glucose profiles gives important information about differences in glucose control and its timing, which are undetectable by standard summary metrics. Women using RT-CGM were able to achieve better daytime glucose control, reducing fetal exposure to maternal glucose.