The Role of Continuous Glucose Monitoring in Managing Hyperglycaemia First Detected in Pregnancy: A Narrative Review

Hyperglycaemia first diagnosed in pregnancy (HIP) is the most common medical condition affecting pregnancy, affecting up to 40% of pregnancies in some countries. The global incidence of HIP is increasing owing to rising rates of overweight and obesity, advanced maternal age, and early screening for HIP. Current guidelines recommend self-monitoring of blood glucose (SMBG) via frequent capillary finger-prick testing, which can be painful and inconvenient, contributing to poor adherence, psychological distress, and suboptimal glycaemic control. Continuous glucose monitoring (CGM) offers an alternative approach, providing real-time, automated glucose readings without the need for repeated invasive testing. This review evaluates the current evidence on the clinical benefits of CGM in HIP, including its effects on glycaemic control, maternal and neonatal outcomes, and patients' quality of life. Although existing studies are limited by small sample sizes and methodological variability, findings suggest that CGM might improve adherence, patient satisfaction, glycaemic control, and neonatal birth weight compared with SMBG. However, the lack of large-scale randomised trials has hindered widespread adoption and reimbursement of CGM for HIP. There is a clear need for more patient-centred glucose monitoring strategies and further research to confirm the long-term benefits of CGM in HIP management and to identify the patient populations most likely to benefit from CGM use. Addressing these gaps is essential to optimising care and improving outcomes for the growing population affected by HIP.