CGM improves glycaemic, neonatal outcomes in pregnant women with T1D

Combining continuous glucose monitoring (CGM) with continuous subcutaneous insulin infusion (CSII) therapy helps keep blood glucose levels low throughout pregnancy and lower the rate of large for gestational age (LGA) delivery, according to a study.

The observational study included 481 women with T1D who were pregnant or planning pregnancy. All participants used CSII therapy, and some of them used CGM with CSII.

Neonatal outcomes (eg, rate of LGA delivery [birth weight > 90th percentile]) and maternal glycaemia (eg, HbA1c and percentage of time at sensor glucose ranges) were assessed and compared between women who used CSII therapy alone and those who used CGM with CSII.

In the entire cohort, HbA1c was 6.8 percent (50.9 mmol/mol; n=354) at the first trimester, 5.8 percent (40.1 mmol/mol; n=318) at the second trimester, and 5.9 percent (41.4 mmol/mol; n=255) at the third trimester. HbA1c target of <6.0 percent (42 mmol/mol) at each trimester was achieved by 74 (20.9 percent), 207 (65.1 percent), and 148 women (58.0 percent), respectively.

Compared with the CSII-only group, the CSII plus CGM group had consistently lower HbA1c levels at trimesters 1 (6.5 percent vs 7.1 percent [47.8 vs 54.3 mmol/mol]; p<0.0001), 2 (5.7 percent vs 6.0 percent [38.9 vs 41.6 mmol/mol; p=0.0122), and 3 (5.8 percent vs 6.1 percent [40.3 vs 42.9 mmol/mol; p=0.0117).

Rates of LGA delivery were 22.7 percent (74 of 326) overall, 24.6 percent (34 of 138) in the CSII-only group, and 21.3 percent (40 of 188) in the CSII plus CGM group.