The one-center experience comparing glucose monitoring in patients with gestational diabetes mellitus utilizing flash glucose monitoring (FGM) versus traditional self-blood glucose monitoring (SBGM)

Abstract

Introduction: The most prevalent condition affecting the metabolism of carbohydrates during pregnancy is gestational diabetes mellitus (GDM). Continuous glycemia monitoring systems that use sensors are currently replacing the conventional self-monitoring of glycemia with a glucometer. Poland's insurance coverage has made new technologies possible for continuous glycemia monitoring. Our retrospective study compared the effects of two glycemic measurement techniques on patient preferences and maternal and pediatric clinical outcomes: traditional methods using a glucometer and utilizing a sensor for scanning continuous glycemic monitoring (Flash Glucose Monitoring, or FGM). Material and methods: In a retrospective analysis of 277 women with GDM treated in the Department of Metabolic Diseases, University Hospital in Cracow, Poland, in January 2023 we compared the effectiveness of using of sensor FreeStyle Libra (FGM) vs self-blood glucose monitoring (SBGM) by glucometer in improving clinical maternal outcomes measured by daily insulin dose, body weight gain, mean blood glucose and newborns outcomes assessed by body weight, APGAR score, caesarean sections. Results: We examined 224 women from the SBGM (self-blood glucose monitoring) group, 53 from the FGM group, and 277 from the GDM ladies. The SBGM group was diagnosed with GDM later in pregnancy [24 (10–25) vs 11 (8–23.5) weeks; p < 0.001], was admitted at the first pregnancy visit [26 (14–29) vs 20 (12–27) weeks; p = 0.001], and was slightly older [33 (30–36) vs 32 (29–34) years; p = 0,027]. The pre-pregnancy body weight [70 (60–83) vs 67 (59–79) kg; p = 0.358] and the number of pregnancies [2 (1–3) vs 2 (1–3); p = 0.118] did not differ between the two groups. Women who used SMGB gained less weight throughout pregnancy [10 (5.5–13.0) vs 12 (8–14.8) kg; p = 0.0333] and had fewer prenatal checkups [5 (4–7) vs 8 (5–9) weeks; p < 0.001], including fewer teleconsultations [1 (0–3)]. Women in the FGM group received insulin treatment earlier [15 (11.5–27) vs 27 (16–30) week of pregnancy; p < 0,001] and used it more often [52 (98.1%) vs 183 (81.3%); p = 0.005]. There was no significant difference in daily insulin dose per kg of weight [26.5 (11.5–39.2) vs 21 (9–39) U/d; p = 0.325]. The groups did not differ in birth weight [SBGM 3243 +/– 485 vs FGM 3331 +/– 359 g; p = 0.206] and a gestational week at delivery [38 (38–39) vs 39 (38–39) week; p = 0.092], There was no difference in obstetric outcomes: caesarean sections, preterm births, week of delivery, mean birth weight or prevalence of perinatal complications. Conclusions: When comparing traditional SBGM to flash continuous glucose monitoring in this real-world observation, we have found no changes in the outcomes for mothers and newborns between the groups. There were more teleconsultations for women who used FCGM.