(1170) Comparing continuous glucose monitoring and blood glucose monitoring among pregnant individuals with Type 2 Diabetes

Objective:
While using continuous glucose monitoring (CGM) in pregnancy may improve outcomes in those with Type 1 diabetes, the benefits of CGM in pregnant patients with Type 2 diabetes (T2DM) is lacking. The objective of our study was to assess maternal and neonatal outcomes with use of CGM versus blood glucose monitoring (BGM) among pregnant individuals with T2DM.

Study Design:
This is a retrospective cohort study (2017-2023) of pregnant individuals with T2DM receiving maternal-fetal medicine (MFM) and endocrinology care at a single institution and managed with either CGM or BGM. The primary outcome was the percentage achieving HbA1c < 6.0% by delivery. Secondary outcomes included maternal and neonatal measures related to glycemic control. Multivariable logistic regression accounting for prenatal care provider team (MFM with or without endocrine co-management), body mass index, gestational weight gain, and comorbid conditions was conducted.

Results:
Of 79 patients, 28 (35%) used CGM and 51 (65%) used BGM during pregnancy. A significantly greater number of CGM users were comanaged by MFM and endocrine. Otherwise, baseline characteristics did not vary significantly between groups. In the adjusted analysis, the percent achieving HbA1c < 6.0% was not significantly different between groups. In addition, there were no significant differences in maternal outcomes including development of hypertensive disorders, diabetic ketoacidosis, polyhydramnios, preterm labor, chorioamnionitis, wound complications, or hospital readmission (Table). Neonatal outcomes, including gestational age at delivery, birth weight, congenital anomalies, hypoglycemia, respiratory distress syndrome, transient tachypnea, hyperbilirubinemia, sepsis, demise, and NICU admission were similar between groups.

Conclusion:
Use of CGM was not associated with improvement in glycemic control or in maternal and neonatal outcomes compared to use of BGM in this small cohort of pregnant individuals with T2DM. Larger studies are needed to assess if CGM use is beneficial in this population.