538-P: Use of Real-Time Continuous Glucose Monitoring Supports Behavior Modification in Gestational Diabetes Mellitus—Results from an Ongoing Pilot Study

Gestational diabetes mellitus (GDM) is common, with 14% of women developing GDM. Although real-time continuous glucose monitoring (RT-CGM) has been shown to support behavioral/lifestyle modifications in patients living with type 1 and type 2 diabetes, no studies to date have assessed RT-CGM as a behavior modification tool for patients with GDM.

Participants diagnosed with GDM [prior to gestational age 24 weeks (early) or between 24-30 weeks (typical)] were randomized to use RT-CGM or continue self-monitoring of blood glucose (SMBG) using finger-sticks and wore 3 serial blinded CGM over the remainder of the pregnancy. Both groups continued their routine obstetric care. After delivery, RT-CGM participants completed a 44-question survey adapted from the Joslin Diabetes Center CGM questionnaire plus our published 8-question survey on behavior modification and CGM use.

To date, 70 participants have enrolled; 31 were randomized to RT-CGM. Twenty-four (4 early and 20 typical) have completed the post-delivery surveys. Demographics: 42% were Caucasian, 63% reported annual incomes of >$50,000, and 79% had achieved at least a bachelor’s degree. From RT-CGM use: 71% excluded or limited sugared beverages (29% never drank sugared beverages), 78% excluded or limited white rice (13% never ate white rice), 67% started reading labels for fiber content (17% of participants already read labels for fiber content), and 92% would walk or increase activity after a meal if they saw their glucose rising. Overall, 92% of participants felt like RT-CGM contributed to a healthier lifestyle during pregnancy. Sixty-three percent wanted to continue using RT-CGM.

Our study suggests that women with GDM perceive that RT-CGM supports improved lifestyle choices during pregnancy. Studies are ongoing to assess whether RT-CGM improves maternal and/or fetal outcomes, but advocacy is needed now to improve accessibility of RT-CGM in GDM.