Du Mengkai, Yi Songjia, Wei Yili, Jiang Yijiong, Bao Shuting, Lu Junjun, Chen Danqing
Department of Obstetrics, Women's Hospital School of Medicine Zhejiang University, No. 1 Bachelor Road, Hubin Street, Shangcheng District, Hangzhou, 310000, China.
Department of Obstetrics, Shengzhou People's Hospital, Shengzhou, 312400, China.
Diabetes Ther. 2025 May 12. doi: 10.1007/s13300-025-01749-0.
This study aims to evaluate the impact of using FreeStyle Libre continuous glucose monitoring (FSL-CGM) on maternal glucose control and obstetric and neonatal outcomes among women with gestational diabetes mellitus (GDM).
A total of 3062 women with GDM in gestational weeks 24-28 were enrolled in this study and divided into FSL-CGM and self-monitoring of blood glucose (SMBG) groups according to the method of monitoring blood glucose. Nearest-neighbor matching propensity score matching (PSM) was used to balance covariates at a ratio of 1:2.
Compared with the first 6 days during the study period, the index of glycemic variability, such as the mean largest amplitude of glycemic excursions (LAGE), average daily risk range (ADRR) and glucose management indicators (GMI) during the last 6 days were improved (all p < 0.05). The fasting blood glucose before delivery in the FSL-CGM group was lower than that in the SMBG group (p < 0.05). In the normal weight subgroup, the FSL-CGM group had a lower gestational weight gain (GWG) than the SMBG group (p < 0.05). The incidence of neonatal hypoglycemia was higher in the SMBG group than in the FSL-CGM group (p < 0.05).
This study demonstrated that FSL-CGM helps reduce maternal glycemic variability and the incidence of neonatal hypoglycemia. Additionally, FSL-CGM may contribute to appropriate gestational weight gain during pregnancy.
ClinicalTrials.gov identifier, NCT05003154.
本研究旨在评估使用FreeStyle Libre连续血糖监测(FSL-CGM)对妊娠期糖尿病(GDM)女性的母体血糖控制以及产科和新生儿结局的影响。
本研究共纳入3062例孕24 - 28周的GDM女性,并根据血糖监测方法将其分为FSL-CGM组和自我血糖监测(SMBG)组。采用倾向评分匹配法(PSM)按1:2的比例平衡协变量。
与研究期间的前6天相比,最后6天的血糖变异性指标,如平均血糖波动幅度(LAGE)、平均每日风险范围(ADRR)和血糖管理指标(GMI)均有所改善(均p < 0.05)。FSL-CGM组分娩前的空腹血糖低于SMBG组(p < 0.05)。在正常体重亚组中,FSL-CGM组的孕期体重增加(GWG)低于SMBG组(p < 0.05)。SMBG组新生儿低血糖的发生率高于FSL-CGM组(p < 0.05)。
本研究表明,FSL-CGM有助于降低母体血糖变异性和新生儿低血糖的发生率。此外,FSL-CGM可能有助于孕期体重的适当增加。
ClinicalTrials.gov标识符,NCT05003154。