Center for Women's Reproductive Health and the Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama; the Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania; the Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and the Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon.
Obstet Gynecol. 2024 Nov 1;144(5):649-659. doi: 10.1097/AOG.0000000000005669. Epub 2024 Jul 17.
Continuous glucose monitoring (CGM) has the potential to revolutionize diabetes management during pregnancy by providing detailed and real-time data to patients and clinicians, overcoming many of the limitations of self-monitoring of blood glucose. Although there are limited data on the role of CGM to improve pregnancy outcomes in patients with type 2 diabetes or gestational diabetes, CGM has been shown to reduce pregnancy complications in patients with type 1 diabetes. Despite the limited data in some populations, given its ease of use and recent U.S. Food and Drug Administration approval with expanding insurance coverage, CGM has gained widespread popularity among pregnant patients with all types of diabetes. It is critical for obstetric clinicians to understand how CGM can be successfully integrated into clinical practice. We present a practical, step-wise approach to CGM data interpretation that can be incorporated into diabetes management during pregnancy and common CGM pitfalls and solutions. Although technology will continue to advance with newer-generation CGM devices and diabetes technology such as automated insulin delivery (not covered here), these key principles form a basic foundation for understanding CGM technology and its utility for pregnant people.
连续血糖监测(CGM)有可能通过向患者和临床医生提供详细和实时的数据来彻底改变妊娠期间的糖尿病管理,克服了自我监测血糖的许多局限性。尽管关于 CGM 在改善 2 型糖尿病或妊娠期糖尿病患者的妊娠结局方面的作用的数据有限,但 CGM 已被证明可降低 1 型糖尿病患者的妊娠并发症。尽管在某些人群中的数据有限,但鉴于其易于使用以及最近美国食品和药物管理局的批准和不断扩大的保险范围,CGM 在所有类型的糖尿病孕妇中都得到了广泛的欢迎。产科临床医生必须了解如何成功地将 CGM 整合到临床实践中。我们提出了一种实用的、逐步的 CGM 数据解释方法,可以将其纳入妊娠期间的糖尿病管理中,并介绍常见的 CGM 陷阱和解决方案。尽管随着新一代 CGM 设备和糖尿病技术(如自动胰岛素输注)的不断进步,技术将继续发展(此处未涵盖),但这些关键原则为理解 CGM 技术及其对孕妇的实用性奠定了基础。