Pregnancy in T1D is associated with increased maternal and fetal morbidity and mortality. Tight glycemic control is correlated with improved outcomes. CGM use during pregnancy is frequently encouraged to help women achieve glucose targets and reduce complications.
CGM use and delivery outcomes are reported from retrospective data from 50 T1D pregnancies from 2/2012-7/2019 in which Dexcom G4, G5, or G6 was used.
Dexcom CGM was used in every trimester in 84% of patients. No patients discontinued use during pregnancy. The median wear time was 93% (range: 52-100%). Women wore sensors on the front and back abdomen, arms, buttocks, and thighs in all stages of pregnancy, labor and delivery, and postpartum period. Pre-eclampsia was diagnosed in 12%; C-section was performed in 60% of births. One fetus had intrauterine growth restriction, and one infant had neonatal respiratory distress. 6% were early pre-term (<34 weeks), and 15% were late pre-term (34-36 weeks). Median birth weight was 3530g (13% >4000g). The Dexcom CGM was well tolerated. One patient had recurrent severe hypoglycemia requiring emergency care prior to starting a sensor, but she had no severe events after starting her Dexcom G5 CGM. No patients experienced severe hypoglycemia or reported severe skin reactions with sensor use.
CGM is a useful and well-tolerated tool to help manage diabetes during pregnancy. Our outcomes, which are better than many of those reported for standard of care, further support the benefits of CGM in T1D pregnancies. Further prospective data are needed to further validate the benefits of CGM use.