Real-Time Continuous Glucose Monitoring in Gestational Diabetes: A Randomized Controlled Trial

Abstract

Objective To evaluate whether real-time continuous glucose monitoring improves glycemic control over intermittent self-monitoring of blood glucose in gestational diabetes. Study Design We performed a single-institution randomized controlled trial. Patients with gestational diabetes were randomized to use either real-time or blinded continuous glucose monitoring. The primary outcome was mean sensor glucose level during the fourth week of continuous glucose monitoring use. Secondary outcomes included glycemic control and a composite of obstetric and neonatal outcomes. Results Of the 40 enrolled patients, 12 (60%) patients in the blinded continuous glucose monitoring group and 11 (55%) in the real-time continuous glucose monitoring group completed 4 weeks of monitoring and were included in the final analysis. There was no significant difference in mean sensor glucose level between the blinded continuous glucose monitoring group (98.9 ± 8.9 mg/dL) and the real-time continuous glucose monitoring group (107.5 ± 11.4 mg/dL). There were also no significant differences in the time spent in glycemic target, maternal, or neonatal outcomes. Conclusion Our study shows that the use of continuous glucose monitoring with real-time feedback did not significantly decrease mean glucose values compared with intermittent self-monitoring of blood glucose after 4 weeks of continuous glucose monitoring use.

Clinical Effectiveness of Different Technologies for Diabetes in Pregnancy: Systematic Literature Review

“…Paramasivam et al [ 34 ] (MQ) found a significant difference in favor of the intervention group (mean 5.2%, SD 0.4% vs mean 5.6%, SD 0.6%; P =.006). Alfadhli et al [ 33 ] ( P =.168) (MQ) and Lane et al [ 36 ] ( P =.3) (SQ) found lower mean HbA 1c values in their intervention groups ( P >.05).…”

“…We identified 4 randomized controlled trials (IG: n=147, CG: n=154). Whereas 3 studies used self-monitoring blood glucose as control [ 33 - 35 ], 1 study used blinded continuous glucose monitoring system which did not display the glucose readings to the participant [ 36 ].…”

“…Alfadhli et al [ 33 ] (MQ) (IG=16.3%, CG=9.5%, P =.373), Paramasivam et al [ 34 ] (MQ) (IG: n=3, 12%; CG: n=1, 4%; P =.609) and Lane et al [ 36 ] (SQ) (IG: n=1, 9.1%; CG: n=2, 16.7%; P >.999) found no significant differences in the occurrence of preterm births.…”

“…Paramasivam et al [ 34 ] (MQ) reported clearly more vaginal deliveries in the intervention group ( P =.258) [ 34 ], while Wei et al [ 35 ] (MQ) ( P =.370) and Lane et al [ 36 ] (SQ) ( P >.999) noted slightly more cesarean deliveries in the control groups.…”

“…Wei et al [ 35 ] ( P =.084), Alfadhli et al [ 33 ] (MQ) ( P =.130) and Paramasivam et al [ 34 ] (MQ) ( P =.311) reported a lower, yet not significant, mean birthweight of newborns in the intervention groups. Lane et al [ 36 ] (SQ) reported a higher mean birthweight of newborns in the intervention group ( P =.4).…”