65-OR: Continuous Glucose Monitoring Metrics and Suboptimal Pregnancy Outcomes in Women with Gestational Diabetes—Secondary Analysis of the DiGest Trial

Background: Continuous glucose monitoring (CGM) is increasingly used in gestational diabetes but the optimal metrics and targets in this population are undefined. We assessed if CGM metrics were associated with pregnancy outcomes in gestational diabetes. Methods: 432 women with gestational diabetes (BMI 25 kg/m2) received a dietary intervention (DiGest trial; ISRCTN; 37866), with masked CGM (Dexcom G6) at 29 (n=332) and 36wks (n=225) respectively. We used logistic regression, adjusted for trial arm, to assess the associations between standardized CGM metrics and pregnancy outcomes, including preeclampsia, preterm delivery, large-for-gestational-age (LGA), admission to the neonatal intensive care unit (NICU) and neonatal hypoglycemia. Time in range (TIR) was defined using 63-120 mg/dl. Results: At 29wks, mean glucose, TIR and time-above-range (TAR) were significantly associated with multiple outcomes, including pre-eclampsia, LGA, NICU admission and neonatal hypoglycemia (table 1). TIR and TAR recalculated using range 63-140mg/dl (3.5-7.8 mmol/l) performed similarly. Glucose SD at 29 and 36wks was significantly associated with LGA. Time-below-range at 36wks was associated with neonatal hypoglycemia (table 1). Conclusions: CGM metrics are strong predictors of multiple relevant pregnancy outcomes in gestational diabetes. Disclosure L.C. Kusinski: None. D. Jones: None. N. Atta: None. E. Turner: None. L.M. Oude Griep: None. K.L. Rennie: None. E. De Lucia Rolfe: None. H.R. Murphy: Advisory Panel; Medtronic. Research Support; Abbott, Dexcom, Inc. Speaker's Bureau; Ypsomed AG, Eli Lilly and Company, Dexcom, Inc. R. Taylor: Advisory Panel; Fast800. C.L. Meek: Research Support; Dexcom, Inc. Funding Diabetes UK 17/0005712EFSD - NNF NNF19SA058974