Continuous glucose monitor use in type 2 diabetes mellitus in pregnancy and perinatal outcomes: a systematic review and meta-analysis

Gianna Wilkie; Veronika Melnik; Lydia Brainard; Sophia Antonioli; Becky Baltich Nelson; Katherine Leung; Heidi Leftwich

doi:10.1016/j.ajogmf.2023.100969

Continuous glucose monitor use in type 2 diabetes mellitus in pregnancy and perinatal outcomes: a systematic review and meta-analysis

Am J Obstet Gynecol MFM. 2023 Jul;5(7):100969. doi: 10.1016/j.ajogmf.2023.100969. Epub 2023 Apr 14.

Authors

Gianna Wilkie¹, Veronika Melnik², Lydia Brainard², Sophia Antonioli², Becky Baltich Nelson², Katherine Leung³, Heidi Leftwich³

Affiliations

¹ Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, MA (Dr Wilkie, Ms Leung, and Dr Leftwich). Electronic address: Gianna.Wilkie@gmail.com.
² University of Massachusetts Chan Medical School, Worcester, MA (Ms. Melnik, Ms. Brainard, Ms. Antonioli, and Ms. Nelson).
³ Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, MA (Dr Wilkie, Ms Leung, and Dr Leftwich).

PMID: 37061044
DOI: 10.1016/j.ajogmf.2023.100969

Abstract

Objective: This study aimed to assess whether continuous glucose monitor use in type 2 diabetes mellitus in pregnancy is associated with improved perinatal outcomes.

Data sources: We searched Ovid MEDLINE, Scopus, ClinicalTrials.gov, and Cochrane library from inception through May 9, 2022.

Study eligibility criteria: We included all studies that compared continuous glucose monitor use with fingerstick glucose monitoring in women with type 2 diabetes mellitus.

Methods: The initial search yielded 2463 unique citations that were screened in Covidence by 2 independent reviewers. Study types included randomized controlled trials, cohort studies, and cross-sectional studies. Our outcomes of interest were macrosomia or large-for-gestational-age infants, hemoglobin A1c, cesarean delivery, hypertensive disorders of pregnancy including preeclampsia, gestational age at delivery, and neonatal hypoglycemia.

Results: Three randomized controlled trials met the inclusion criteria. We performed random-effects meta-analyses of estimates from 2 studies without risk of significant bias and reported summary adjusted odds ratios and 95% confidence intervals. Meta-analysis of 56 women with continuous glucose monitor use and 53 control women without continuous glucose monitor use showed that there was no difference in the incidence of large-for-gestational-age infants between continuous glucose monitor users and standard-of-care controls (odds ratio, 0.78; 95% confidence interval, 0.34-1.78) with an I² of 0%. In addition, there was no difference in the development of preeclampsia between continuous glucose monitor users and standard-of-care controls (odds ratio, 1.63; 95% confidence interval, 0.34-7.22) with an I² of 0%.

Conclusion: Continuous glucose monitor use was not associated with improved perinatal outcomes as assessed by large-for-gestational-age infants and preeclampsia. This review is limited by the small amount of data available for this population, and further research is needed.

Keywords: continuous glucose monitor; pregestational diabetes mellitus; pregnancy; type 2 diabetes mellitus.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Blood Glucose
Blood Glucose Self-Monitoring*
Cross-Sectional Studies
Diabetes Mellitus, Type 2* / drug therapy
Diabetes, Gestational* / diagnosis
Diabetes, Gestational* / drug therapy
Female
Humans
Pre-Eclampsia* / epidemiology
Pregnancy

Substances

Blood Glucose