Poster Session 1
Category: Diabetes
Poster Session 1
Claire A. McIlwraith, MD
Fellow Physician, Maternal Fetal Medicine
Center for Research in Women’s Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
Yumo Xue, PhD
Post-Doctoral Fellow
Center for Research in Women’s Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
Madeline Evans, BS
Medical Student
Heersink School of Medicine, University of Alabama at Birmingham
Birmingham, Alabama, United States
Ashley N. Battarbee, MD, MSCR
Associate Professor, Maternal-Fetal Medicine
Center for Research in Women’s Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
Continuous glucose monitoring (CGM) improves pregnancy outcomes in patients with type 1 diabetes and is increasingly being used in patients with type 2 diabetes, but many do not start CGM until after conception. We sought to understand if timing of CGM initiation during pregnancy was associated with adverse outcomes.
Study Design:
This was a retrospective cohort study of pregnant patients with type 1 and type 2 diabetes with a singleton gestation who started using CGM during pregnancy and delivered at a single tertiary care center from 2018-2024. We excluded patients with fetal anomalies and pregnancy loss < 23 weeks. Data were abstracted by electronic medical record review by trained personnel to ensure accuracy. Patients were compared based on timing of CGM initiation: early at < 14 weeks versus late at ≥ 14 weeks’ gestation. Our primary outcome was large for gestational age (LGA) infant based on Fenton curves. Multivariable logistic regression estimated the association between early CGM initiation and outcomes. Additionally, we tested for effect modification by diabetes type (1 vs 2) and evaluated GA of CGM initiation as a continuous variable.
Results:
Of 232 patients included, 93 (40%) initiated CGM early (mean 7.3±4.8 weeks) and 139 (60%) initiated CGM late (22.3±5.3 weeks). Groups differed by many baseline characteristics (Table 1). LGA did not differ between groups (24.7% vs 20.1%; aOR 0.97, 95% CI 0.45-2.10). Secondary maternal and neonatal outcomes were also similar (Table 2). Findings were consistent in analyses stratified by diabetes type and when evaluating GA at CGM initiation as a continuous variable.
Conclusion:
In this cohort, the timing of CGM initiation was not associated with a significant difference in maternal or neonatal outcomes. Even when early CGM initiation is not possible due to barriers like delayed prenatal care or insurance approval, CGM should still be considered later in pregnancy, as it may offer comparable benefits.