Use of CGM by pregnant women with type 1 diabetes improves health of mother and baby
Posted on 15 September 2017
JDRF-funded researchers have announced today that pregnant women living with type 1 diabetes who used a continuous glucose monitor, or CGM, throughout their pregnancy in a major trial had better blood glucose control and healthier babies.
High blood glucose levels during pregnancy increase the risk of complications.
Managing blood glucose levels during pregnancy however is difficult because insulin requirements and insulin absorption can vary greatly day-to-day. Drs Denice Feig and Helen Murphy therefore wanted to test whether using a CGM during pregnancy could help mothers to manage their blood glucose levels, and lead to better health outcomes for their babies.
What did they do?
The team recruited 214 pregnant women from six countries, including the UK, Canada, Spain and Italy. Half of the women were given a CGM to use in conjunction with their insulin pump or multiple daily insulin injections, and the rest of the women carried on with their care the same as before, without a CGM.
The women attended check-ups throughout their pregnancy to have their HbA1c and time spent in range monitored, and the team then analysed the health outcomes of the babies born.
What did they find?
Pregnant women who were in the CGM group had reduced HbA1c and spent an average of 100 minutes longer in the target glucose range each day than those not using a CGM. Their babies were also more likely to be born at a healthy weight, and half as likely to be admitted to an intensive care unit.
Dr Helen Murphy said:
“The benefit of having an international trial is that these results are important to women with type 1 diabetes across all countries.”
What does this mean for type 1?
These findings are encouraging news for women living with type 1 diabetes, as they indicate that CGM use can improve care during pregnancy, and help mothers to deliver healthy babies. On the implications of their findings, Dr Helen Murphy said:
“We would recommend that CGM be offered to all pregnant women with type 1 diabetes during the first trimester.”
What’s the next step?
The trial indicated that using a CGM during pregnancy was broadly beneficial, whether on a pump or multiple daily injections. The team have now indicated that they would like to have a closer look at the data from the women who didn’t see as much of a benefit from the CGM, and explore if they might benefit more from other technology, such as closed-loop systems.
JDRF’s Pregnancy Toolkit has more information about conceiving and pregnancy and type 1 diabetes. To download the free toolkit please click here.
Derek Rapp, International President and CEO of JDRF
“JDRF is proud to have supported this multinational trial that shows that the use of continuous glucose monitors during pregnancy has positive clinical outcomes for both mother and baby, across all countries where the study took place. This study will serve as a catalyst for improved access to life-saving CGM technology worldwide.
We hope that these results will help people with type 1 diabetes to be confident in their decision to have children and help them make informed choices with their doctors about care.”
Professor Helen Murphy, co-principal investigator of CONCEPTT
“Women using insulin pumps and insulin injections benefitted equally, meaning our results are applicable to all pregnant women with type 1 diabetes. Although continuous monitoring is more expensive than standard glucose testing, there is potential for substantial healthcare savings.
“An admission to the neonatal intensive care unit is far more expensive than continuous glucose monitoring during pregnancy.
“These results should influence clinical practice so that all women with type 1 diabetes have the best possible chance of having a healthy baby.”
A JDRF supporter's story of using a CGM during pregnancy and birth.
“I am in love. I don’t know who with, but if you can tell me who designed and built the continuous glucose monitor I’ll go find him or her to express my undying devotion.”
Click below to read grandmother Judith’s story of her grown-up daughter Miriam’s experience with a continuous glucose monitor (CGM) and how it helped when Miriam herself gave birth.
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