What question did this study set out to answer?

This research investigates the impact of continuous glucose monitoring on both glycemic and clinical outcomes in pregnancies affected by type 1 diabetes.

January 14, 2026

Pregnancy Outcomes in Patients with Type 1 Diabetes Using Continuous Glucose Monitoring

Key Points

This research investigates the impact of continuous glucose monitoring on both glycemic and clinical outcomes in pregnancies affected by type 1 diabetes.
Retrospective cohort study of patients with T1DM at a large health system from 2016 to 2023.
Primary outcomes: glycemic control and composite maternal morbidity including preeclampsia and diabetic ketoacidosis.
Compared outcomes between patients using CGM and traditional capillary blood glucose monitoring.
Adjusted odds ratios calculated using multivariable logistic regression.
CGM users had better midtrimester glycemic control (40.7% vs 17.5%, aOR 2.32).
No significant difference in composite outcomes between CGM and traditional groups (CGM: 42.8% vs TBGM: 49.0%; aOR 0.70).
Stricter targets in CGM users linked to improved glycemic control and reduced preterm deliveries (18.8% vs 56.9%, aOR 0.16).
Fewer NICU admissions in CGM users with stricter targets (37.5% vs 60%, aOR 0.37).

Abstract

Objective Continuous glucose monitoring (CGM) use among patients with type 1 diabetes (T1DM) has been associated with improved glycemic control, though improvement in non-glycemic outcomes is less consistent. We hypothesize that CGM use in patients with T1DM in a real-world clinical setting is associated with both improved glycemic and clinical outcomes. Study Design This was a retrospective cohort study of patients with T1DM receiving care at a large health system from 2016 to 2023. Primary outcomes included: 1) glycemic control and 2) a composite comprised of severe maternal morbidity, preeclampsia with severe features, delivery prior to 34 weeks, and admission for diabetic ketoacidosis. Primary glycemic outcome was Hb A1c < 6% in the 2nd trimester. Patients using CGM were then evaluated by device setting, with those set to targets consistent with American Diabetes Association (ADA) recommendations compared to those with more permissive goals. Adjusted odds ratios were calculated using multivariable logistic regression to adjust for potential confounding variables. Results Among 288 patients with T1DM, there were 145 deliveries in the CGM group and 143 in the traditional capillary blood glucose monitoring group. Midtrimester on-target glycemic control was improved in the CGM group compared to traditional monitoring (40.7% vs 17.5%, aOR 2.32; 95% CI 1.21-4.12). There was no difference in composite outcome (CGM: 42.8% vs TBGM: 49.0%, aOR 0.70; 95%CI 0.40-1.22), nor was there a difference in secondary outcomes. In patients using CGM, stricter targets were associated with improved glycemic control as well as reduced preterm delivery (18.8% vs 56.9%, aOR 0.16, CI 0.05-0.48) and NICU admission (37.5% vs 60%,aOR 0.37, CI 0.14-0.96). Conclusion CGM use in T1DM is associated with improved glycemic control throughout pregnancy, however this does not uniformly translate to improved clinical outcomes. Lack of adherence to ADA blood glucose targets may contribute to these findings.

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