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Real-Time Continuous Glucose Monitoring in Gestational Diabetes: A Randomized Controlled Trial
Andrew S Lane1, Malgorzata A Mlynarczyk1, Margarita de Veciana1
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia.
American Journal of Perinatology
|March 1, 2019
Summary
Real-time continuous glucose monitoring (CGM) did not significantly improve glycemic control compared to intermittent self-monitoring in gestational diabetes. This study found no significant difference in glucose levels or outcomes between the two monitoring methods.
Area of Science:
- Endocrinology
- Obstetrics
- Medical Technology
Background:
- Gestational diabetes requires careful glycemic control to prevent maternal and neonatal complications.
- Continuous glucose monitoring (CGM) offers real-time glucose data, potentially improving management over traditional intermittent self-monitoring of blood glucose (SMBG).
Purpose of the Study:
- To determine if real-time CGM enhances glycemic control in patients with gestational diabetes compared to intermittent SMBG.
- To assess the impact of real-time CGM on obstetric and neonatal outcomes.
Main Methods:
- A single-institution randomized controlled trial was conducted.
- Patients with gestational diabetes were assigned to either real-time CGM or blinded CGM groups.
- The primary outcome was mean sensor glucose during the fourth week of monitoring.
Main Results:
- No significant difference in mean sensor glucose levels was observed between the real-time CGM (107.5 ± 11.4 mg/dL) and blinded CGM (98.9 ± 8.9 mg/dL) groups.
- Time spent within glycemic targets and composite maternal/neonatal outcomes did not differ significantly between groups.
- Completion rates for 4 weeks of monitoring were 55% for real-time CGM and 60% for blinded CGM.
Conclusions:
- Real-time CGM feedback did not lead to a significant reduction in mean glucose values compared to intermittent SMBG in gestational diabetes after 4 weeks.
- Current evidence suggests real-time CGM may not offer superior glycemic control benefits over intermittent SMBG for this population within this timeframe.
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