Continuous glucose monitoring improved glycemic control in pregnant women with diabetes

Continuous glucose monitoring improved glycemic control in the third trimester, lowered birth weight and reduced risk for macrosomia among pregnant women with diabetes in a study recently published in BMJ.

A prospective, randomized, controlled trial conducted by researchers at Ipswich Hospital, and other sites in the United Kingdom, analyzed the efficacy of continuous glucose monitoring on maternal glycemic control, birth weight and risk for macrosomia in pregnant women with type 1 and type 2 diabetes.

The study included 71 pregnant women with type 1 (n=46) or type 2 diabetes (n=25) who were randomly assigned to antenatal care plus continuous glucose monitoring (n=38) or antenatal care alone (n=33). Participants were aged between 16 and 45 years.

Two women from the continuous monitoring arm withdrew from the study due to pain after sensor insertion and unwillingness to participate after the first profile was downloaded.

HbA1c levels were consistently lower in the continuous monitoring group, though no significant difference was found in the mean levels between the two groups until 28 and 32 weeks of gestation. At that point, mean HbA1c levels were 6.1% in the intervention arm, compared with 6.4% in the control arm. The trend was not statistically significant, however (P=.1).

Between 32 and 36 weeks of gestation, HbA1c levels reduced to 5.8% in the intervention arm and remained at 6.4% in the control arm (P=.007).

According to the researchers, infants of mothers in the intervention arm had lower mean birth weight standard deviation scores (0.9 vs. 1.6; effect size 0.7 SD), lower median customized birth weight percentiles (69% vs. 93%) and a reduced risk for macrosomia (OR=0.36), compared with infants of mothers in the control arm.

BMJ. 2008;337:a1680.