Continuous Glucose Monitor Use in Pregnancy

A continuous glucose monitor (CGM) can provide detailed insight into daily glucose fluctuations and individual glucose patterns, and it is advised for patients with type 1 diabetes mellitus and advanced type 2 diabetes mellitus (T2DM). Despite this recommendation, pregnant women are not receiving the same standard of care. It has been studied minimally in pregnant women with T2DM, despite preliminary studies showing improvement in adverse perinatal outcomes and glycemic control among pregnant women with type 1 diabetes. Therefore, there is a paucity of data regarding CGM use among pregnant women with T2DM, and significant potential to reduce the significant multigenerational effects associated with diabetes in pregnancy with this technology.

The study team therefore propose to perform a randomized controlled trial among 180 pregnant women with T2DM comparing CGM use to the standard of care of multiple daily fingerstick glucose monitoring and its impact on large for gestational age infants, maternal glycemic control, patient satisfaction, and additional adverse perinatal outcomes.

Inclusion criteria

Women will be deemed eligible for the study by the following inclusion criteria:

• 1) age greater than or equal to 18 years old
• 2) singleton gestation less than or equal to 14 weeks at initial obstetric visit
• 3) established diagnosis of T2DM by laboratory criteria including hemoglobin A1c ≥6.5%, oral glucose tolerance test ≥200 mg/dL, or fasting plasma glucose ≥126 mg/dL
• 4) receiving prenatal care at UMASS Memorial Health Care (UMMHC) and plans to deliver at UMMHC
• 5) able and willing to provide informed consent

Exclusion criteria

Women will be deemed ineligible for the study based on the following exclusion criteria:

• 1) known diagnosis of type 1 diabetes or gestational diabetes
• 2) plan to receive prenatal care or delivery outside of UMMHC
• 3) inability to provide informed consent
• 4) multifetal gestation