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August 19, 2025Open Access

Continuous glucose monitoring metrics and pregnancy outcomes in women with gestational diabetes: a secondary analysis of the DiGest trial

Key Points

Participants achieving mean glucose below 110mg/dL at 29 weeks had a significantly lower risk of adverse pregnancy outcomes.
CGM metrics were significantly linked to both large for gestational age and small for gestational age outcomes, indicating critical thresholds.
Analysis employing logistic regression and receiver-operator-curves assessed CGM metrics to predict pregnancy results effectively.
Findings suggest the importance of maintaining specific CGM targets to reduce the risk of preterm birth and other complications.

Abstract

OBJECTIVE: Continuous glucose monitoring (CGM) is increasingly used in gestational diabetes mellitus (GDM) but optimal metrics, ranges and targets in this population are undefined. We assessed associations between CGM metrics and pregnancy outcomes in gestational diabetes. RESEARCH DESIGN AND METHODS: During the DiGest study, 425 women with GDM (diagnosed at median (IQR) 25.1 (18.3- 27.7) weeks) and BMI ≥25kg/m2 received a dietary intervention, with masked Dexcom G6 CGM at 29 (n=361), 32 (n=215) and 36 weeks (n=227) gestation. For this secondary analysis, we used logistic regression, receiver-operator-curves and Youden index to assess associations and predictive ability of CGM metrics including pregnancy-specific time-in-range (TIRp; 63-140mg/dL; 3.5-7.8mmol/L) and pregnancy outcomes. RESULTS: CGM metrics at 29 weeks were significantly associated with LGA and SGA. Participants achieving mean glucose CONCLUSIONS: In women with GDM, CGM mean glucose

Continuous glucose monitoring metrics and pregnancy outcomes in women with gestational diabetes: a secondary analysis of the DiGest trial

Key Points

Abstract

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