The Effect of Continuous Glucose Monitoring on Gestational Diabetes Mellitus Management in High BMI Pregnancies [ID 3360]

INTRODUCTION: The objective was to compare maternal and neonatal outcomes in women with gestational diabetes mellitus (GDM) monitored with continuous glucose monitoring (CGM) versus self-monitoring of blood glucose (SMBG), stratified by body mass index (BMI). METHODS: This is a retrospective study (2022–2024) of singleton pregnancies with gestational diabetes diagnosed in the second/third trimesters. The study compared outcomes based on monitoring (SMBG versus CGM) and stratified by BMI (30). Outcomes studied include hypertensive disorders (HTD), primary cesarean delivery (CD) rates, macrosomia, shoulder dystocia, stillbirths, hypoglycemia, hyperbilirubinemia, and neonatal intensive care unit admissions. Pregestational diabetes and multiple gestations were excluded. RESULTS: One hundred forty-one women with GDM were included in the study: 112 women used SMBG and 29 used CMG. Caucasian, non-Hispanic, and privately insured women are more likely to use CMG ( P <.05). Interval BMI change is lower with CGM ( P =0.09). Primary CD was 36.9% in SMBG versus 14.3% in CGM ( P =0.02). No significant differences were observed in other maternal and neonatal outcomes studied ( P >.05). Among 100 women with BMI greater than 30, 80 women used SMBG and 20 used CGM. Primary CD was 43% in SMBG and 15.8% in CMG ( P =.03). No significant differences were noted in other outcomes studied ( P >.05). Among 41 women with BMI less than 30 (CGM 32 and SMBG 9 women), outcomes, including CD rates, were similar in both groups ( P >.05). CONCLUSIONS/IMPLICATIONS: Use of CGM significantly varies by race/ethnicity and insurance type. Continuous glucose monitoring was associated with a nonsignificant trend towards reduced interval weight gain. Use of CGM in GDM, especially in women with high BMI, is associated with lower primary CD rates.