Roadmap to the Effective Use of Continuous Glucose Monitoring in Pregnancy

Author:

Murphy Helen R.1ORCID

Affiliation:

1. Norwich Medical School, University of East Anglia, Norwich, U.K., and Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, U.K.

Abstract

The landscape for managing type 1 diabetes during pregnancy has been transformed by increasing use of continuous glucose monitoring (CGM). Women are aiming for pregnancy-specific glucose targets or 70% time in range for pregnancy (TIRp; 63–140 mg/dL) as soon as possible, knowing that every extra 5% TIRp has benefits for reducing the risks of complications in their babies. Ongoing monitoring of maternal A1C (at pregnancy confirmation and at 20, 28, and 36 weeks’ gestation) remains useful. Intensification of glycemic management and instruction in using CGM (if not already used) is recommended for individuals with an A1C >6.0% after 20 weeks. A better understanding of CGM-documented glycemic changes throughout pregnancy is needed to inform future management of gestational diabetes and pregnancy in people with type 2 diabetes. Research regarding overcoming barriers to CGM use and optimal TIRp targets for pregnant individuals with type 2 diabetes from diverse racial/ethnic groups is urgently needed.

Publisher

American Diabetes Association

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

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