Balaji Bhavadharini, Hannah Wesley, Popova Polina V, Ram Uma, Deepa Mohan, Lunghar Janeline, Uthra Kumaran, Sagili Haritha, Kamalanathan Sadishkumar, Anjana Ranjit Mohan, Mohan Viswanathan
Madras Diabetes Research Foundation, Chennai, India.
Department of Epidemiology, Madras Diabetes Research Foundation, Chennai, India.
J Diabetes Sci Technol. 2025 Jul 23:19322968251357873. doi: 10.1177/19322968251357873.
Continuous glucose monitoring (CGM) has emerged as an important tool for managing gestational diabetes mellitus (GDM), offering real-time glucose data and the potential for improved glycemic control. Unlike traditional self-monitoring of blood glucose (SMBG), which provides intermittent readings, CGM captures continuous glucose fluctuations, including postprandial and nocturnal changes, which are critical in GDM management.
This systematic review aimed to assess the effectiveness of CGM compared with SMBG in managing glycemic control in women with GDM, focusing on key glycemic metrics such as time in range (TIR) and glycemic variability (GV), and exploring their associations with maternal and neonatal outcomes.
A comprehensive search of PubMed and Google Scholar was conducted, adhering to PRISMA guidelines. Studies included randomized controlled trials, observational studies, and prospective cohort studies comparing CGM and SMBG, with 35 studies ultimately reviewed.
Compared with SMBG, CGM demonstrated significant improvements in maintaining TIR and reducing GV, which correlated with favorable maternal and neonatal outcomes, including lower rates of large-for-gestational-age (LGA) infants, preterm birth, and NICU (neonatal intensive care unit) admissions. Furthermore, CGM detected more hyperglycemic and hypoglycemic events, particularly nocturnal fluctuations. However, the studies also highlighted the need for standardized metrics to optimize CGM use in GDM management.
Continuous glucose monitoring offers substantial advantages over SMBG for managing GDM by providing continuous, real-time glucose data, enabling timely treatment adjustments. These findings support the integration of CGM into clinical practice to improve maternal and neonatal outcomes in GDM. Further research is needed to establish standardized CGM metrics specific to GDM management.
连续血糖监测（CGM）已成为管理妊娠期糖尿病（GDM）的一项重要工具，可提供实时血糖数据，并具有改善血糖控制的潜力。与传统的自我血糖监测（SMBG）不同，SMBG提供的是间歇性读数，而CGM可捕捉连续的血糖波动，包括餐后和夜间变化，这些变化在GDM管理中至关重要。
本系统评价旨在评估CGM与SMBG相比在管理GDM女性血糖控制方面的有效性，重点关注关键血糖指标，如血糖达标时间（TIR）和血糖变异性（GV），并探讨它们与母婴结局的关联。
按照PRISMA指南对PubMed和谷歌学术进行了全面检索。纳入的研究包括比较CGM和SMBG的随机对照试验、观察性研究和前瞻性队列研究，最终共审查了35项研究。
与SMBG相比，CGM在维持TIR和降低GV方面有显著改善，这与良好的母婴结局相关，包括巨大儿（LGA）、早产和新生儿重症监护病房（NICU）入院率较低。此外，CGM检测到更多的高血糖和低血糖事件，尤其是夜间波动。然而，研究也强调需要标准化指标以优化CGM在GDM管理中的应用。
连续血糖监测通过提供连续、实时的血糖数据，为GDM管理提供了比SMBG更多的优势，能够及时调整治疗。这些发现支持将CGM纳入临床实践，以改善GDM患者的母婴结局。需要进一步研究以建立特定于GDM管理的标准化CGM指标。
