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目的:运用持续血糖监测(CGM)探讨不同孕期的初诊妊娠期糖尿病(GDM)患者的血糖特征。方法:将163例初诊GDM患者根据其孕周分为孕中期组(n n＝86)和孕晚期组(n n＝77)。所有GDM患者均进行CGM，计算血糖波动指标，并使用血糖五角模型(CGP)评估监测结果，比较2组患者的血糖特征。使用线性回归分析HbAn 1C与血糖波动指标的相关性。比较2组患者的起始胰岛素治疗比例。n 结果:与孕中期患者相比，孕晚期患者血糖标准差、日间血糖平均绝对差、血糖超出目标范围的时间和CGP面积显著升高，血糖达标时间占比显著降低，差异有统计学意义(均n P<0.05)。2组患者早餐后的餐后血糖波动幅度均高于午餐与晚餐(n P<0.01)。多重线性回归分析显示，HbAn 1C仅与平均血糖显著相关(n β＝0.014，95%n CI 0.006～0.018, n P<0.01)。与孕中期患者相比，孕晚期患者起始胰岛素治疗患者比例更高，但是差异无统计学意义(23.4%对14.0%,n P＝0.121)。n 结论:孕晚期初诊GDM患者的血糖波动幅度更大，高血糖状况更严重，血糖达标时间占比更低，早餐后的餐后血糖波动幅度为全天餐后血糖波动幅度之最。CGM得到的血糖波动指标和CGP参数较HbAn 1C能更全面而精准地反映患者的血糖波动特征及状况。n “,”Objective:To observe the glycemic profiles in newly diagnosed gestational diabetes mellitus(GDM)with different trimesters by continuous glucose monitoring(CGM).Methods:One hundred and sixty-three GDM patients were categorized into the second trimester(n n=86)and the third trimester(n n=77)groups. CGM was initially performed, and the comprehensive glucose pentagon(CGP)was evaluated. The glycemic variability parameters between two groups were compared. The linear regression was used to analyze correlation between HbAn 1C and glycemic variability parameters. The proportions of insulin initiation between two groups were compared.n Results:Compared with GDM in the second trimester, patients in the third trimester had higher standard deviations of blood glucose, means of daily differences, times out of range, areas of CGP, and less times in range(all n P<0.05). Moreover, postprandial glucose excursions after breakfast were higher than those after lunch and dinner in both two groups(n P<0.01). Multivariate linear regression analysis showed that HbAn 1C was independently correlated with mean blood glucose(n β=0.014, 95%n CI 0.006-0.018, n P<0.01). Patients in the third trimester had a higher proportion of insulin initiation than those in the second trimester, but the difference was not statistically significant(23.4%n vs 14.0%, n P=0.121).n Conclusion:Newly diagnosed GDM patients in the third trimester had higher glycemic variability and less time in range. Postprandial glucose after breakfast seemed to be the peak of the whole day. The glycemic variability and CGP parameters derived from CGM may comprehensively and accurately reflect glycemic profile better than the value of HbAn 1C.n