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First-trimester continuous glucose monitoring parameters in preeclamptic and normotensive patients with type 1

Daniel Boroń1, Urszula Mantaj1, Rafał Sibiak1

  • 1Department of Reproduction, Chair of Feto-maternal Medicine, Poznan University of Medical Sciences, Poland.

Diabetes Research and Clinical Practice
|October 17, 2025
PubMed

Insights

First-trimester glucose monitoring in type 1 diabetes (T1D) may predict preeclampsia. Continuous glucose monitoring (CGM) metrics like mean glucose and variability show potential for early risk assessment in T1D pregnancies.

Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Diabetes Management

Background:

  • Preeclampsia is a serious pregnancy complication that disproportionately affects women with pregestational type 1 diabetes (T1D).
  • Early identification of T1D pregnancies at high risk for preeclampsia is crucial for timely intervention and improved outcomes.

Purpose of the Study:

  • To evaluate the predictive capability of continuous glucose monitoring (CGM)-derived metrics during the first trimester for preeclampsia development in pregnancies complicated by T1D.
  • To compare the predictive power of CGM metrics against standard glycemic markers.

Main Methods:

  • A retrospective cohort study involving women with T1D on sensor-augmented insulin pump (SAP) therapy was conducted.
  • First-trimester CGM data, including mean glucose, time in range (TIR), coefficient of variation (CV%), and glucose monitoring indicator (GMI), were analyzed.
  • Preeclampsia diagnosis followed ISSHP criteria, and data were compared between women who developed preeclampsia and those who did not.

Main Results:

  • Of 70 women, 13 (18.6%) developed preeclampsia.
  • Women who developed preeclampsia had significantly higher first-trimester mean glucose (121.6 mg/dL vs. 112.3 mg/dL, p = 0.0012) and lower TIR (63.3% vs. 70.16%, p = 0.03).
  • Higher glucose variability, indicated by coefficient of variation, was also observed in the preeclampsia group, though not statistically significant (p=0.055).

Conclusions:

  • Elevated first-trimester mean glucose and glucose variability are associated with preeclampsia development in women with T1D.
  • Continuous glucose monitoring (CGM) shows promise in refining risk models for preeclampsia in T1D pregnancies.
  • These findings support the use of CGM for early detection of glycemic imbalances that may predict preeclampsia.
Abstract

Keywords:
Continuous glucose monitoringPlacental insufficiencyPreeclampsiaPregnancy complicationsTime in rangeType 1 diabetesVascular programming

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