Continuous Glucose Monitoring and Glycemic Patterns in Pregnant Women with Gestational Diabetes Mellitus.

Continuous glucose monitoring (CGM) could detect certain patterns of hyperglycemia at different times of the day that may help predict the development of maternal-fetal complications and the probability of needing pharmacological treatment. This study prospectively examined 77 women with gestational diabetes mellitus (GDM) who were placed on a CGM system for 6 days after diagnosis between 26 and 32 weeks of gestation. Patterns of hyperglycemia before meals (period of time of an hour just before meal) (>95 mg/dL), after meals (time interval of 2 h and half just after meal) (>140 mg/dL), and overnight (0-7 am) (>120 mg/dL) and their association with maternal-fetal complications and pharmacological treatment were analyzed. Receiver operating characteristic curves were developed to estimate the validity of the various patterns in detecting the need for pharmacological treatment. A statistically significant relationship was observed between time in hyperglycemia after lunch and macrosomia ( = 0.035) and large for gestational age infants ( = 0.010). Pharmacological treatment was required for patients with time above range (TAR;  = 0.006) and those with hyperglycemia patterns before breakfast ( < 0.001), after breakfast ( = 0.006), before dinner ( = 0.012), and overnight ( = 0.001). Every additional percentage point of TAR was associated with a 24% increase in the probability of pharmacological treatment. The use of CGM for the diagnosis of GDM allows the identification of those patients who would benefit from closer monitoring during pregnancy, including self-monitoring of both pre- and postprandial blood glucose levels, facilitating the initiation of early pharmacological treatment.