Continuous Glucose Monitoring through pregnancy
If you are planning a pregnancy, currently pregnant, or have recently had a baby and have type 1 or type 2 diabetes, you know how crucial it is to maintain healthy glucose levels for both your and your baby’s wellbeing. This often involves frequent blood glucose checks through finger pricks or using Continuous Glucose Monitoring (CGM).
Why consider CGM?
Continuous Glucose Monitoring (CGM) is approved for use in pregnancy for women with type 1, type 2, and gestational diabetes. It allows you to track your glucose levels continuously, providing a clear guide for insulin adjustments and better diabetes management, helping to reduce the risk of complications.
How CGM can help you
1. Real-time tracking: CGM monitors your glucose levels 24/7, giving you detailed information on whether your levels are in the target range, too high, or too low (hypoglycaemia). This helps you make necessary adjustments to your diet, exercise, and medication.
2. Easy access to data: You can see your glucose levels on your smartphone via an app, or with the Freestyle Libre 2, also through a reader. This data can be shared with your healthcare team to help them understand your needs better and discuss management recommendations with you.
3. Personalised input: You can add important information like insulin doses, meal times, snacks, and exercise routines to make the data more meaningful and useful for managing your diabetes.
4. Support and training: When you start using CGM, you’ll receive training to understand how to use it effectively. Knowing how to track and interpret your glucose levels helps you and your healthcare team make informed decisions.
5. Improved management: CGM helps identify when you need to adjust your management plan for more stable glucose levels, which is vital for your and your baby’s health.
6. Preventing low glucose levels: CGM can alert you in real-time if your glucose levels are dropping, allowing you to take immediate action. This can prevent hypoglycaemia in newborns.
7. Fewer finger pricks: Although occasional finger pricks are still recommended if your CGM reading doesn’t match how you feel, CGM significantly reduces the need for frequent finger pricks.
Should you invest in CGM?
Studies show that CGM benefits both mothers and babies. For women with type 1 diabetes, CGM is particularly beneficial before, during, and after pregnancy. Women with type 2 diabetes also benefit, though more studies are needed. For gestational diabetes, short-term CGM use can be helpful, especially when adjusting diet and exercise or using insulin. The CONCEPT trial highlighted CGM’s advantages during pregnancy.
Cost and coverage
CGM is fully covered by the National Diabetes Services Scheme (NDSS) for women with type 1 diabetes who are planning a pregnancy, are pregnant, or have recently given birth. For women with type 2 diabetes and gestational diabetes, CGM is not covered by NDSS, but private health insurance might offer some rebates. It is also worth checking for special offers from the companies.
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- Freestyle Libre: Each sensor costs around $102 and lasts for 14 days. A smartphone or Android device is needed to receive data via an app. There is a special offer for one sensor at $15. Freestyle Libre Offer
- Dexcom G6: A 3-pack (one-month supply) of sensors costs $330, with each sensor lasting up to 10 days. The transmitter, which lasts for three months, costs $400. Dexcom G6
- Medtronic Guardian System: Each sensor lasts 7 days. You’ll also need a rechargeable transmitter and a compatible iOS or Android device. Medtronic Guardian System
Post-pregnancy use
Many women with type 1 diabetes find that continuing to use CGM and an insulin pump after pregnancy significantly improves their quality of life. Women with type 2 diabetes might choose to return to traditional blood glucose monitoring after their baby is born, depending on personal preference and cost considerations.
CGM offers a comprehensive way to manage your diabetes more effectively during pregnancy, helping ensure better health outcomes for both you and your baby.
REFERENCES
1. Denice S Feig 1, Lois E Donovan 2, Rosa Corcoy 3, Kellie E Murphy 4 et.al
Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial 2017 Accessed May 25 2024
https://pubmed.ncbi.nlm.nih.gov/28923465/
2. The Continuous glucose monitoring (CGM) in type 1 diabetes pregnancy study. Commencing date July 2023 -Type 1 diabetes in pregnancy, proving that technology can make all the difference.Accessed May30 2024
Written by Joy Kingdom (RN CDE)
