Introduction and Objective: We compared perinatal outcomes among pregnancies complicated by type 2 diabetes (T2D) managed with continuous glucose monitoring (CGM) to self-monitored blood glucose (SMBG).Methods: Patients with pre-pregnancy T2D, singleton gestation, and delivery between 2018-2024 at two health systems were identified by ICD-10 codes. Patient demographics and outcomes were abstracted and compared between those managed with SMBG versus CGM antenatally. Multivariable logistic regression was performed.Results: Of the 964 pregnancies meeting inclusion criteria, 179 (18.6%) used CGM. Baseline characteristics including BMI, Hba1c at first prenatal visit, and mean HbA1c across pregnancy were similar between groups. Those using CGM were more likely to use insulin at pregnancy onset (45.9% vs 25.6%, p<0.001) and delivery (92.7% vs 74.8%, p<0.001). CGM use was associated with higher insulin doses at delivery (118 vs 80 units, p<0.001) despite similar starting doses (56 vs 50 units, p=0.19), as well as increased gestational weight gain (20.2 vs 16.5 lbs, p=0.01). CGM use in pregnancy led to higher odds of large-for-gestational age infants, neonatal composite morbidity, and neonatal hypoglycemia (Table).Conclusion: CGM did not improve outcomes in our patient population. More data regarding optimal CGM targets and randomized clinical trials comparing CGM to SMBG are needed prior to widespread adoption of CGM for pregnancies complicated by T2D.
K. Pape: None. K. Crites: None. M. Mai: None. K. Sherman: None. A.M. Altavilla: None. C.E. Linczer Kabele: None. E.M. Cleary: None. C. Scifres: None.
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