Using flash glucose monitoring in pregnancies in routine care of patients with gestational diabetes mellitus: a pilot study

Aim Flash glucose monitoring (FGM) has been approved for the care of pregnant women with preexisting diabetes since 2017. However, its use in gestational diabetes (GDM) has been critically discussed. Inaccuracy and missing recommendations for target values are the main arguments against the use of F...

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Veröffentlicht in:Acta diabetologica 2023-05, Vol.60 (5), p.697-704
Hauptverfasser: Bastobbe, Sophie, Heimann, Yvonne, Schleußner, Ekkehard, Groten, Tanja, Weschenfelder, Friederike
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container_issue 5
container_start_page 697
container_title Acta diabetologica
container_volume 60
creator Bastobbe, Sophie
Heimann, Yvonne
Schleußner, Ekkehard
Groten, Tanja
Weschenfelder, Friederike
description Aim Flash glucose monitoring (FGM) has been approved for the care of pregnant women with preexisting diabetes since 2017. However, its use in gestational diabetes (GDM) has been critically discussed. Inaccuracy and missing recommendations for target values are the main arguments against the use of FGM in GDM. To date, there is a lack of data to justify routine use of FGM in GDM pregnancies. Consequently, this new technology has been withheld from GDM-patients. Aim of our pilot study was to analyze the impact of FGM use on pregnancy outcomes, patient’s satisfaction and to confirm the safe use in GDM pregnancies. Methods Cohort study of 37 FGM-managed GDM pregnancies compared with 74 matched women using self-monitoring of blood glucose (SMBG). Group comparison using nonparametric testing concerning patients characteristic and perinatal outcome focusing on adverse outcomes (preeclampsia, preterm delivery, large for gestational age, C-sections, neonatal intensive care unit admission, hyperbilirubinemia and hypoglycemia). Evaluation of patient’s treatment satisfaction using the “Diabetes Treatment Satisfaction Questionnaire change” (DTSQc) and patient interviews. Results No significant differences in patient’s characteristics despite gestational age at diagnosis (FGM with 20 vs. SMBG with 25 weeks). No difference in gestational weight gain, HbA1c progression and perinatal outcome. Treatment satisfaction obtained by the DTSQc revealed a high level of satisfaction with FGM use. Conclusion FGM use was well accepted and did not affect perinatal outcome. Use of FGM during pregnancy is safe and non-inferior to the management with SBGM. FGM should be considered as an option in the management of GDM patients.
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However, its use in gestational diabetes (GDM) has been critically discussed. Inaccuracy and missing recommendations for target values are the main arguments against the use of FGM in GDM. To date, there is a lack of data to justify routine use of FGM in GDM pregnancies. Consequently, this new technology has been withheld from GDM-patients. Aim of our pilot study was to analyze the impact of FGM use on pregnancy outcomes, patient’s satisfaction and to confirm the safe use in GDM pregnancies. Methods Cohort study of 37 FGM-managed GDM pregnancies compared with 74 matched women using self-monitoring of blood glucose (SMBG). Group comparison using nonparametric testing concerning patients characteristic and perinatal outcome focusing on adverse outcomes (preeclampsia, preterm delivery, large for gestational age, C-sections, neonatal intensive care unit admission, hyperbilirubinemia and hypoglycemia). Evaluation of patient’s treatment satisfaction using the “Diabetes Treatment Satisfaction Questionnaire change” (DTSQc) and patient interviews. Results No significant differences in patient’s characteristics despite gestational age at diagnosis (FGM with 20 vs. SMBG with 25 weeks). No difference in gestational weight gain, HbA1c progression and perinatal outcome. Treatment satisfaction obtained by the DTSQc revealed a high level of satisfaction with FGM use. Conclusion FGM use was well accepted and did not affect perinatal outcome. Use of FGM during pregnancy is safe and non-inferior to the management with SBGM. FGM should be considered as an option in the management of GDM patients.</description><identifier>ISSN: 1432-5233</identifier><identifier>ISSN: 0940-5429</identifier><identifier>EISSN: 1432-5233</identifier><identifier>DOI: 10.1007/s00592-023-02042-x</identifier><identifier>PMID: 36840782</identifier><language>eng</language><publisher>Milan: Springer Milan</publisher><subject>Blood Glucose ; Blood Glucose Self-Monitoring ; Cohort Studies ; Diabetes ; Diabetes mellitus ; Diabetes, Gestational - diagnosis ; Diabetes, Gestational - therapy ; Female ; Gestational age ; Gestational diabetes ; Glucose monitoring ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Infant, Newborn ; Internal Medicine ; Medicine ; Medicine &amp; Public Health ; Metabolic Diseases ; Neonates ; Original ; Original Article ; Patients ; Pilot Projects ; Pre-eclampsia ; Pregnancy ; Pregnancy and diabetes ; Pregnancy complications ; Pregnancy Outcome</subject><ispartof>Acta diabetologica, 2023-05, Vol.60 (5), p.697-704</ispartof><rights>The Author(s) 2023</rights><rights>2023. 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However, its use in gestational diabetes (GDM) has been critically discussed. Inaccuracy and missing recommendations for target values are the main arguments against the use of FGM in GDM. To date, there is a lack of data to justify routine use of FGM in GDM pregnancies. Consequently, this new technology has been withheld from GDM-patients. Aim of our pilot study was to analyze the impact of FGM use on pregnancy outcomes, patient’s satisfaction and to confirm the safe use in GDM pregnancies. Methods Cohort study of 37 FGM-managed GDM pregnancies compared with 74 matched women using self-monitoring of blood glucose (SMBG). Group comparison using nonparametric testing concerning patients characteristic and perinatal outcome focusing on adverse outcomes (preeclampsia, preterm delivery, large for gestational age, C-sections, neonatal intensive care unit admission, hyperbilirubinemia and hypoglycemia). Evaluation of patient’s treatment satisfaction using the “Diabetes Treatment Satisfaction Questionnaire change” (DTSQc) and patient interviews. Results No significant differences in patient’s characteristics despite gestational age at diagnosis (FGM with 20 vs. SMBG with 25 weeks). No difference in gestational weight gain, HbA1c progression and perinatal outcome. Treatment satisfaction obtained by the DTSQc revealed a high level of satisfaction with FGM use. Conclusion FGM use was well accepted and did not affect perinatal outcome. Use of FGM during pregnancy is safe and non-inferior to the management with SBGM. 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Evaluation of patient’s treatment satisfaction using the “Diabetes Treatment Satisfaction Questionnaire change” (DTSQc) and patient interviews. Results No significant differences in patient’s characteristics despite gestational age at diagnosis (FGM with 20 vs. SMBG with 25 weeks). No difference in gestational weight gain, HbA1c progression and perinatal outcome. Treatment satisfaction obtained by the DTSQc revealed a high level of satisfaction with FGM use. Conclusion FGM use was well accepted and did not affect perinatal outcome. Use of FGM during pregnancy is safe and non-inferior to the management with SBGM. FGM should be considered as an option in the management of GDM patients.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>36840782</pmid><doi>10.1007/s00592-023-02042-x</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3553-4056</orcidid><oa>free_for_read</oa></addata></record>
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subjects Blood Glucose
Blood Glucose Self-Monitoring
Cohort Studies
Diabetes
Diabetes mellitus
Diabetes, Gestational - diagnosis
Diabetes, Gestational - therapy
Female
Gestational age
Gestational diabetes
Glucose monitoring
Humans
Hyperbilirubinemia
Hypoglycemia
Infant, Newborn
Internal Medicine
Medicine
Medicine & Public Health
Metabolic Diseases
Neonates
Original
Original Article
Patients
Pilot Projects
Pre-eclampsia
Pregnancy
Pregnancy and diabetes
Pregnancy complications
Pregnancy Outcome
title Using flash glucose monitoring in pregnancies in routine care of patients with gestational diabetes mellitus: a pilot study
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