The risks associated with diabetes in pregnancy include congenital anomalies, stillbirth and miscarriage, and correlate with glycaemia. The optimisation of diabetes during pregnancy is therefore both challenging and essential. Technology has revolutionised how clinicians and patients manage diabetes. This review article focuses on the role of continuous glucose monitoring (CGM) in pregnancy, assessing the evidence available and providing an update on current guidance.
AliSDornhorstA.Diabetes in pregnancy: health risks and management. Postgrad Med J2011;
87: 417–427.
2.
National Institute for Health and Care Excellence (NICE). Diabetes in pregnancy: management from preconception to the postnatal period.
London:
NICE, 2015, www.nice.org.uk/guidance/ng3 (accessed 17 December 2020).
3.
ParsonsJSparrowKIsmailK, et al.
Experiences of gestational diabetes and gestational diabetes care: a focus group and interview study. BMC Pregnancy Childbirth2018;
18: 25.
4.
The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med2008;
359: 1464–1476.
5.
BattelinoTPhillipMBratinaN, et al.
Effect of continuous glucose monitoring on hypoglycaemia in type 1 diabetes. Diabetes Care2011;
34: 795–800.
6.
PolonskyWHesslerD.What are the quality of life-related benefits and losses associated with real-time continuous glucose monitoring? A survey of current users. Diabetes Technol Ther2013;
15: 295–301.
RebrinKSheppardNSteilG.Use of subcutaneous interstitial fluid glucose to estimate blood glucose: revisiting delay and sensor offset. J Diabetes Sci Technol2010;
4: 1087–1098.
9.
Association of British Clinical Diabetologists (ABCD). Using diabetes technology in pregnancy. Best practice guideline.
West Midlands:
ABCD, 2020.
10.
NHS Digital. National Pregnancy in Diabetes (NPID) Audit 2018. Report, England Wales and the Isle of Man 2019.
11.
KerssenAValkHVisserG.The continuous glucose monitoring system during pregnancy of women with type 1 diabetes mellitus: accuracy assessment. Diabetes Technol Ther2004;
6: 645–651.
12.
BühlingKJKurzidimBWolfC, et al.
Introductory experience with the continuous glucose monitoring system (CGMS; Medtronic Minimed) in detecting hyperglycemia by comparing the self-monitoring of blood glucose (SMBG) in non-pregnant women and in pregnant women with impaired glucose tolerance and gestational diabetes. Exp Clin Endocrinol Diabetes2004;
112: 556–560.
13.
ScottEBilousR and Kautzky-Willer.
Accuracy, user acceptability, and safety evaluation for the freestyle Libre flash glucose monitoring system when used by pregnant women with diabetes. Diabetes Technol Ther2018;
20: 180–188.
14.
CastorinoKPolsySO’MalleyG, et al.
Performance of the dexcom G6 continuous glucose monitoring system in pregnant women with diabetes. Diabetes Technol Ther2020;
22: 943–947.
15.
YogevYBen-HaroushAChenR, et al.
Continuous glucose monitoring for treatment adjustment in diabetic pregnancies – a pilot study. Diabetic Med2003;
20: 558–562.
16.
MclachlanKJenkinsAO’NealD.The role of continuous glucose monitoring in clinical decision-making in diabetes in pregnancy. Obstet Gynaecol2007;
47: 186–190.
17.
MurphyHRaymanGLewisK, et al.
Effectiveness of continuous glucose monitoring in pregnant women with diabetes: randomised clinical trial. Bmj2008;
337: a1680.
18.
PetrovskiGDimitrovskiCBogoevM, et al.
Is there a difference in pregnancy and glycemic outcome in patients with type 1 diabetes on insulin pump with constant or intermittent glucose monitoring? A pilot study. Diabetes Technol Ther2011;
13: 1109–1113.
19.
SecherARingholmLAndersenHU, et al.
The effect of real-time continuous glucose monitoring in pregnant women with diabetes. A randomised controlled trial. Diabetes Care2013;
36: 1877–1883.
20.
VoormolenDDeVriesJHSansonR, et al.
Continuous glucose monitoring during diabetic pregnancy (GlucoMOMS): a multicentre randomized controlled trial. Diabetes Obes Metab2018;
20: 1894–1902.
21.
YuQArisITanKH, et al.
Application and utility of continuous glucose monitoring in pregnancy: a systematic review. Front Endocrinol (Lausanne)2019;
10: 697.
22.
JovanovicL.The role of continuous glucose monitoring in gestational diabetes mellitus. Diabetes Technol Ther2004;
2: 67–71.
23.
PerssonBHansonUMarcusC.Gestational diabetes mellitus and paradoxical fetal macrosomia – a case report. Early Hum Dev1995;
41: 203–213.
24.
ScottEFeigDMurphyH, et al.
Continuous glucose monitoring in pregnancy: importance of analyzing temporal profiles to understand clinical outcomes. Diabetes Care2020;
43: 1178–1184.
25.
LawGAlnajiAAlrefaiiL, et al.
Suboptimal nocturnal glucose control is associated with large for gestational age in treated gestational diabetes mellitus. Diabetes Care2019;
42: 810–815.
26.
FeigDDonovanLCorcoyR, et al.
Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet2017;
390: 2347–2359.
27.
CorduaSSecherARingholmL, et al.
Real-time continuous glucose monitoring during labour and delivery in women with Type 1 diabetes – observations from a randomized controlled trial. Diabet Med2013;
30: 1374–1381.
28.
FarrarDCampbellM.Does continuous glucose monitoring during pregnancy improve glycaemic and health outcomes in women with type 1 diabetes? – What the CONCEPTT trial adds. Ann Transl Med2018;
6: 188.
29.
MurphyHFeigDSanchezJJ, et al.
Modelling potential cost savings from use of real-time continuous glucose monitoring in pregnant women with type 1 diabetes. Diabet Med2019;
36: 1652–1658.
BattelinoTDanneTBergenstalR, et al.
Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care2019;
42: 1593–1603.
33.
GabbayMRodackiMCalliariLE, et al.
Time in range: a new parameter to evaluate blood glucose control in patients with diabetes. Diabetol Metab Syndr2020;
12: 22.
KristensenKÖggeLESengpielV, et al.
Continuous glucose monitoring in pregnant women with type 1 diabetes: an observational cohort study of 186 pregnancies. Diabetologica2019;
62: 1143–1153.
