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Continuous glucose monitoring: is it helpful in pregnancy?
Elizabeth Z Byrne1, Howard C Zisser, Lois Jovanovic
1Sansum Diabetes Research Institute, Santa Barbara, California 93105, USA.
The effects of diabetes in pregnancy were first noticed in the beginning of the 19(th) century. Today approximately seven percent of all pregnancies in the United States are affected by gestational diabetes. Since becoming more knowledgeable of the disease, the medical community has developed diagnostic criteria for detecting gestational diabetes and has created treatment options for lowering the risk of adverse fetal outcomes. A pregnancy affected by diabetes is associated with macrosomia, fetal malformations, spontaneous preterm delivery, and labor complications. These risks can be minimized by tight glycemic control through diet, insulin, and attentive monitoring of blood glucose levels. Although most pregnant diabetic women currently monitor their diabetes using self-monitoring blood glucose, the technology of continuous glucose monitoring (CGM) offers a myriad of benefits. This mini-review looks at the advantages of using CGM in pregnancy which includes decreasing the risks of poor fetal outcomes, improving a patient's overall glucose profile, helping start or adjust insulin treatment, adjusting current screening protocol and developing a normoglycemic target for gestational diabetic women to aim for during their pregnancy. With the use of CGM, the complications of diabetic pregnancies first seen nearly two centuries ago will become a problem of the past.
The effects of diabetes in pregnancy were first noticed in the beginning of the 19(th) century. Today approximately seven percent of all pregnancies in the United States are affected by gestational diabetes. Since becoming more knowledgeable of the disease, the medical community has developed diagnostic criteria for detecting gestational diabetes and has created treatment options for lowering the risk of adverse fetal outcomes. A pregnancy affected by diabetes is associated with macrosomia, fetal malformations, spontaneous preterm delivery, and labor complications. These risks can be minimized by tight glycemic control through diet, insulin, and attentive monitoring of blood glucose levels. Although most pregnant diabetic women currently monitor their diabetes using self-monitoring blood glucose, the technology of continuous glucose monitoring (CGM) offers a myriad of benefits. This mini-review looks at the advantages of using CGM in pregnancy which includes decreasing the risks of poor fetal outcomes, improving a patient's overall glucose profile, helping start or adjust insulin treatment, adjusting current screening protocol and developing a normoglycemic target for gestational diabetic women to aim for during their pregnancy. With the use of CGM, the complications of diabetic pregnancies first seen nearly two centuries ago will become a problem of the past.
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