1041-P: Differences in Meeting Trimester-Specific HbA1c Goals in T1D Pregnancies Utilizing CGM vs. SMBG in a T1D Specialty Clinic

Abstract

Glycemic control significantly affects the risk for developing adverse gestational health outcomes in pregnancies affected by type 1 diabetes (T1D) . Utilizing continuous glucose monitoring (CGM) in T1D pregnancies has been shown to improve maternal glucose control. We examined the effect of CGM use in meeting HbA1c goals by trimester in T1D pregnancies in a real-world setting.We did a retrospective chart view to identify T1D pregnancies managed at the Barbara Davis Center (BDC) for T1D with either CGM therapy (n=82) or self-monitoring of blood glucose (SMBG) (n=78) over a 6.5-year period (1/1/14 to 8/31/20) . CGM use was defined as >60% wear in the 2nd and 3rd trimesters. HbA1c goals were defined as ≤6.5% in Trimester 1 (T1) and ≤6% in Trimester 2 (T2) and Trimester 3 (T3) , per guidelines by the American Diabetes Association. Baseline characteristics and HbA1c were obtained from the electronic medical record system.CGM users had a significantly higher rate of commercial insurance use (Table) , while other baseline characteristics were similar between groups. CGM users were more likely to meet HbA1C goals in all trimesters (Table) . More than half of SMBG users did not meet HbA1C goals in any trimester (Table) .CGM use significantly increased the likelihood of meeting trimester-specific HbA1c goals in each trimester throughout pregnancy among women with T1D in this real-world study. Disclosure E.Malecha: None. V.Gao: None. E.Westfeldt: n/a. J.K.Snell-bergeon: Stock/Shareholder; GlaxoSmithKline plc. S.Polsky: Advisory Panel; Medtronic, Other Relationship; diaTribe, Research Support; Dexcom, Inc., Eli Lilly and Company, Leona M. and Harry B. Helmsley Charitable Trust, Medtronic, National Institute of Diabetes and Digestive and Kidney Diseases, Sanofi-Aventis U.S. Funding National Institutes of Health (P30-DK116073)