Real-Time Continuous Glucose Monitoring Demystifies Glycemic Management in Pregnancy and Improves Both Fetal and Maternal Outcomes

In an interview with OBG Management, Dr. Celeste Durnwald explains the benefits of real-time continuous glucose monitoring (RT-CGM) in pregnancy. Risk to fetal, neonatal, and maternal well-being is increased in pregnancy complicated by diabetes. While most patients obtain 7 to 8 glucose values over 24 hours with self-monitoring of blood glucose (SMBG), RT-CGM collects approximately 288 readings daily. In this manner, RT-CGM may help pregnant women align their carbohydrate intake and insulin dosing throughout the day to prevent hyperglycemia while avoiding sudden hypoglycemic events, all without the burden of finger sticks. The CONCEPTT trial showed that only 6 patients would need to use RT-CGM to prevent 1 large-for-gestational-age infant, 8 patients to prevent a case of neonatal hypoglycemia, and 6 patients to prevent a neonatal intensive care unit (NICU) stay. Based on these findings and other published literature, consensus guidelines recommend the use of RT-CGM in pregnant women with pre-existing type 1 and type 2 diabetes, as well as in those with gestational diabetes. These findings offer insights for payer professionals seeking to implement evidence-based quality improvement programs in diabetes or obstetrics.

Durnwald CP. Real-Time Continuous Glucose Monitoring Use in Pregnant Patients From A-to-Z. OBG Management. August 2022.