1200-P: A1C and Neonatal Outcomes Improved with Real-Time Continuous Glucose Monitoring in Pregnant Women with Preexisting Type 2 Diabetes

Abstract

Preexisting type 2 diabetes (T2D) in pregnancy is increasing and confers significant health risks to the mother and fetus. Continuous glucose monitoring (CGM) systems provide real-time feedback for patients and allow for remote monitoring and therapeutic adjustments. CGM is ideal for pregnancy where insulin requirements and glucose levels are rapidly changing throughout the pregnancy and postpartum. Previous studies have demonstrated improved maternal and neonatal outcomes with the use of CGM in the context of T1D. This study used the Dexcom G6 CGM in pregnant women with preexisting T2D to determine if there is a reduction of A1C and neonatal hypoglycemia compared to preexisting T2D in women using self-monitored blood glucose (SMBG) to manage their diabetes. Women aged 18-40 years with preexisting T2D, using multiple daily insulin injections, and <14 weeks pregnant were enrolled in the study. Participants were randomly assigned to use G6 or SMBG during pregnancy. Mann Whitney U Test, Wilcoxon Signed Rank Test, and Chi-square tests were used to analyze gestational age (GA), A1C at baseline and at 34 weeks, and occurrence of neonatal hypoglycemia. Fourteen participants completed the study. In the G6 group (n=7, median age 28 years, GA 37 weeks), A1c decreased from 7.0% to 6.1% (p=0.045). In the SMBG group (n=7, median age 36 years, GA 38 weeks), A1c decreased from 6.3% to 6.1% (p=NS). There was no significant difference in the GA between the groups. None of the 7 infants in the G6 group had perinatal hypoglycemia compared to 4 out of 7 infants in the SMBG group (p=0.005). This study suggests that use of the DexcomG6 CGM in preexisting T2D during pregnancy can lower A1C and reduce neonatal hypoglycemia. Disclosure G.Nunlee-bland: Research Support; Dexcom, Inc. P.Cofie: None. Funding Dexcom, Inc. (11S-2019-037)