(470) Pregnancy Outcomes In People with Diabetes Using Continuous Glucose Monitoring

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: Continuous glucose monitoring (CGM) is increasingly used among individuals with diabetes during pregnancy. Our aims were to describe CGM metrics and to assess pregnancy outcomes by type of diabetes; Type 2 diabetes (T2DM)/ gestational diabetes(GDM) versus Type 1 (T1DM) in pregnant people utilizing CGM.

Study Design: We conducted a retrospective cohort study of all individuals using CGM during pregnancy from January 2017 to June 2022 at a quaternary center. Individuals with missing CGM or delivery data were excluded. We evaluated CGM metrics such as time in range (TIR), average blood glucose as well as neonatal and maternal outcomes. Primary composite neonatal outcome included any of the following: large for gestational age, NICU admission, need for IV glucose, or respiratory support, or fetal/neonatal death.

Results: During the study period, of 141 individuals with diabetes utilized CGM during pregnancy, among them 122 (87%) met inclusion criteria (n=5 missing CGM data, n=14 missing delivery data). Of the study population, 57 (46.7%) had T1DM and 65 (53.3%) had T2DM or GDM. Individuals with T1DM were younger, had a lower BMI and were more likely to utilize insulin pump during pregnancy compared to those with T2DM/GDM. Individuals with T1DM has a lower TIR (48.9% vs 75.3%, p< 0.001), with a higher average glucose (155 vs 127, p< 0.001) (Table 1). Composite primary outcome was more likely to occur in neonates of patients with T1DM (77.2% vs 52.3%, p=.006). Furthermore, people with T1DM were more likely to be admitted for glucose optimization (22.8% vs 6.2%, p=0.017), and to have a preterm delivery for any indication (59.6% vs 38.5%) (Table 2).

Conclusion: In this cohort of diabetic individuals managed with CGM, people with T1DM and T2DM had different CGM metrics during pregnancy with a lower TIR and worse neonatal outcomes for people with T1DM. With frequent use of CGM for people with diabetes during pregnancy, there is an urgent need to better define recommended targets for people with diabetes based on the type of diabetes.

Primary & Presenting Author(s)

Ghamar Bitar, MD
Department of Obstetrics, Gynecology and Reproductive Sciences McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States

Coauthor(s)

JC
John Cornthwaite, PhD
Rice University
Houston, Texas, United States
JA
Joy A. Ashby Cornthwaite, RD, CDE, MS
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States
Sarah Nazeer, MD (she/her/hers)
Maternal-Fetal Medicine Fellow
Department of Obstetrics, Gynecology & Reproductive Health Sciences, University of Texas
Houston, Texas, United States
DG
Danna Ghafir, BA
Department of Obstetrics, Gynecology and Reproductive Sciences McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States
SS
Sandra Sadek, MD
University of Texas Science Center Houston
Houston, Texas, United States
TG
Tala Ghorayeb, MD
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States
ND
Nahla Daye, MD
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston
Houston, Texas, United States
Suneet P. Chauhan, MD
Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States
Baha M. Sibai, MD
Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States
Michal Fishel Bartal, MD, MS (she/her/hers)
Maternal Fetal Medicine Faculty
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States