Introduction: Real time continuous glucose monitoring (RTCGM) has been shown to improve glycemic control. Limited data are available on the effects of RTCGM during pregnancy. The current study assesses glycemic control and obstetric outcomes in women with type 1 diabetes, comparing RTCGM with usual self measurement of blood glucose (SMBG).
Patients and methods: Patients were recruited from two hospitals. All patients were eligible. Glycemic control was assessed by preconception HbA1c and HbA1c during pregnancy. Obstetric outcomes reported are premature delivery (PD, <37 weeks), and macrosomia (Large for Gestational Age (LGA; birth weight ≥90th percentile; Very Large for Gestational Age (VLGA; birth weight ≥97.7th percentile).
Results: 67 women were included; 53 (79%) used RTCGM PD occurred in 22% of the pregnancies, 19.6% with RTCGM, 31% on SMBG (P=0.5). LGA occurred in 58% of pregnancies, VLGA in 31%. LGA with RTCGM 61%, with SMBG 46% (P=0.4). VLGA with RTCGM 37.5%, SMG 50%, P=0.9). Mean HbA1c was significantly lower before pregnancy (52.1±6.1 vs 67.8±18.4 mmol/mol, P<0.001) and during the first trimester (6 weeks: 47.9±5.4 vs 58.9±18.1 mmol/mol, P=0.002) and 12 weeks (43.9±7.0 mmol/mol vs 53.6±12.8 mmol/mol, P<0.05), but not later in pregnancy.
Conclusion: RTCGM was associated with better early HbA1c. Premature delivery occurred less frequently with RTCGM, macrosomia more frequent. Future analysis with this expanding group will assess whether these differences persist; at this moment, better early control is not readily associated with less macrosomia.
20 - 23 May 2017
European Society of Endocrinology