Use of a real time continuous glucose monitoring system as an educational tool for patients with gestational diabetes

Abstract

Background: Women with gestational diabetes mellitus (GDM) are required to control their blood glucose shortly after GDM diagnosis to minimize adverse pregnancy outcomes. A real time-continuous glucose monitoring system (RT-CGMS) provides the patient with continuous information about the alterations in levels of the blood glucose. This visibility may empower the patient to modify her lifestyle and engage in therapeutic management. The aim of this study was to determine whether a single application of RT-CGMS to pregnant women shortly after GDM diagnosis is useful as an educational and motivational tool. Methods: This study was a prospective open label randomized controlled study conducted at Maternity and Children Hospital, Medina, Saudi Arabia. A total of 130 pregnant women with GDM were randomised to either blood glucose self-monitor alone (SMBG group) (n = 62) or in addition to SMBG, patients wore a Guardian® REAL-Time Continuous Glucose Monitoring System (Medtronic MiniMed) once for 3-7 days, within 2 weeks of GDM diagnosis (RT-CGMS group) (n = 68). The primary outcomes were maternal glycemic control and pregnancy outcomes. Secondary outcomes were the changes in parameters of glucose variability, which includes mean sensor readings, standard deviation (SD) of blood glucose, and area under the curve for hyper and hypoglycaemia at the end of the RT-CGMS application. Results: HbA1c, mean fasting and postprandial glucose levels were similar in both groups at the end of the pregnancy. Pregnancy outcomes were comparable. However, there was significant improvement in the parameters of glucose variability on the last day of sensor application; both mean glucose and the SD of mean glycaemia were reduced significantly; P = 0.016 and P = 0.034, respectively. The area under the curve for hyper and hypoglycaemia were improved, however, the results were not statistically significant. Conclusion: Although a single application of RT-CGMS shortly after GDM diagnosis is helpful as an educational tool, it was not associated with improvement in glycemic control or pregnancy outcomes.