A review of CONCEPTT study findings including subanalyses in pregnant women using continuous glucose monitoring with type 1 diabetes and their offspring

Abstract

The main objective of this manuscript is to provide a comprehensive review of continuous glucose monitoring use in pregnant women with type 1 diabetes from the CONCEPTT study including sub-analyses. Literature search was accessed through MEDLINE (1966 – September 2023) using the key terms: CONCEPTT, pregnancy, women, type 1 diabetes, and continuous glucose monitor with imitations set to distinguish human subjects written in English. A total of 17 publications including one main clinical trial and 15 sub-analyses have been published to date regarding the use of CGM in pregnant women with T1D which were conducted by a research group identified as the CONCEPTT Collaborative Group. While advances in maternal care have resulted in safer pregnancy for both the mother and child, women with pre-existing T1D and pregnancy still experience higher rates of complications both short and long term. The use of CGM in pregnancy has not been studied extensively until more recently. The CONCEPTT clinical trial was a landmark study that involved several sub analyses. The main trial proved that CGM use in T1D pregnancy resulted in less hyperglycemia in the 3rd trimester, reduced large for gestational age (LGA, >90th centile), reduced neonatal intensive care unit (NICU) admissions lasting longer than 24 hours, and reduced neonatal hypoglycemia. Although sub analyses showed a variety of results including “inconclusive” due to lack of pre-specification, it is believed that CGM in T1D during pregnancy is to be recommended and used for overall improved outcomes.