BES2025 BES 2025 CLINICAL STUDIES (21 abstracts)
Continuous glucose monitoring metrics and pregnancy outcomes in type 1 diabetes: a secondary analysis of the cristal trial
Ina Geerts 1 , Kaat Beunen 1 , Nancy Van Wilder 2 , Dominique Ballaux 3 , Gerd Vanhaverbeke 4 , Youri Taes 5 , Xavier-Philippe Aers 6 , Frank Nobels 7 , Liesbeth Van Huffel 7 , Joke Marlier 8 , Dahae Lee 9 , Joke Cuypers 10 , Vanessa Preumont 11 , Sarah E. Siegelaar 12,13 , Rebecca C. Painter 14,15 , Annouschka Laenen 16 , Pieter Gillard 1,17 , Chantal Mathieu 1,17 & Katrien Benhalima 1,17
1Clinical and Experimental Endocrinology, KU Leuven; 2University Hospital Brussels; 3Vitaz Sint-Niklaas Moerland; 4AZ Groeninge Kortrijk; 5AZ Sint-Jan Brugge; 6AZ Delta Campus Rumbeke; 7AZORG Hospital Aalst; 8University Hospital Ghent; 9Imelda Hospital Bonheiden; 10AZ Turnhout Campus Sint-Jozef; 11University Hospital Saint-Luc; 12Endocrinology and Metabolism, Amsterdam UMC; 13Gastroenterology Endocrinology and Metabolism, Amsterdam UMC; 14Obstetrics & Gynecology, Amsterdam UMC; 15Amsterdam Reproduction and Development, Amsterdam UMC; 16Center of Biostatics and Statistical Bioinformatics, KU Leuven; 17University Hospitals Leuven
Introduction: More data are needed regarding specific continuous glucose monitoring (CGM) metrics and their association with pregnancy outcomes in women with type 1 diabetes (T1D). Therefore, this study aims to examine the association between various CGM metrics and pregnancy outcomes in women with T1D.
Methods: The CRISTAL study was a randomized controlled trial, comparing the MiniMed™ 780G with standard insulin therapy in 95 pregnant women with T1D and indicated improved pregnancy-specific time in range (TIRp) overnight (1). This secondary analysis assessed the association between CGM metrics and pregnancy outcomes. Logistic regression and Spearman correlations, adjusted for baseline HbA1c, were used to analyze binary and continuous outcomes. Data are presented as odds ratios with 95% confidence intervals.
Results: Each 5% increase in TIRp was associated with lower odds of gestational hypertension (0.63; 0.41-0.97), birthweight <4.5 kg (0.56; 0.32–0.96) and neonatal hypoglycemia requiring neonatal care (0.09; 0.01-0.57). Each 5% increase in TIRp overnight reduced the odds of gestational hypertension (0.71; 0.52- 0.98) and neonatal care for hypoglycemia (0.15; 0.03-0.79). Each 5% increase in time above the pregnancy-specific range (TARp) was associated with birthweight <4.5 kg (1.76; 1.05-2.96), respiratory distress (1.55; 1.02-2.37), and neonatal hypoglycemia requiring neonatal care (5.1; 1.14-22.78). Every 5 mg/dl increase in mean glycemia was associated with higher odds for respiratory distress (1.54; 1.07-2.23), while every 5 mg/dl increase in glucose standard deviation raised the odds of gestational hypertension (1.69; 1.02-2.80) and birthweight <4.5 kg (2.31; 1.20-4.43).
Conclusion: Our findings indicate that, along with TIRp and TARp, overnight TIRp, mean glycemia and glycemic variability are important predictors of pregnancy outcomes.
Reference: 1. Benhalima K, Beunen K, Van Wilder N, et al. Comparing advanced hybrid closed loop therapy and standard insulin therapy in pregnant women with type 1 diabetes (CRISTAL): a parallel-group, open-label, randomised controlled trial. 12(6),390–403 (2024).
Keywords: Continuous glucose monitoring, type 1 diabetes, pregnancy outcomes
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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