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Flash glucose monitoring addition to self-monitoring of blood glucose and perinatal outcomes in gestational diabetes: a randomized controlled trial.

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Τίτλος: Flash glucose monitoring addition to self-monitoring of blood glucose and perinatal outcomes in gestational diabetes: a randomized controlled trial.
Συγγραφείς: Zorko K; Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Munda A; Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Janež A; Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Pongrac Barlovič D; Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. Electronic address: drazenka.pongrac@kclj.si.
Πηγή: American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2026 Aug; Vol. 235 (2), pp. 375-384. Date of Electronic Publication: 2026 Apr 02.
Τύπος έκδοσης: Journal Article; Randomized Controlled Trial
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Country of Publication: United States NLM ID: 0370476 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6868 (Electronic) Linking ISSN: 00029378 NLM ISO Abbreviation: Am J Obstet Gynecol Subsets: MEDLINE
Imprint Name(s): Publication: <2005->: New York : Elsevier
Original Publication: St. Louis.
Ιατρικοί όροι (MeSH): Diabetes, Gestational*/blood , Blood Glucose Self-Monitoring*/methods , Blood Glucose*/metabolism , Blood Glucose*/analysis, Fetal Macrosomia/epidemiology ; Humans ; Female ; Pregnancy ; Adult ; Continuous Glucose Monitoring ; Infant, Newborn ; Infant, Large for Gestational Age ; Pregnancy Outcome
Περίληψη: Background: Self-monitoring of blood glucose represents the standard for glycemic monitoring in gestational diabetes mellitus, while the role of continuous glucose monitoring remains uncertain.
Objective: To assess whether adjunctive flash glucose monitoring improves achievement of established self-monitored glucose targets compared with self-monitoring alone and to examine maternal and neonatal outcomes.
Study Design: We conducted an open-label, single-center, randomized controlled trial comparing adjunctive flash glucose monitoring plus self-monitoring of blood glucose with self-monitoring of blood glucose alone. The prespecified primary outcome was the percentage of self-monitored glucose measurements within the established target range. Secondary outcomes included maternal and neonatal outcomes. Analyses followed the intention-to-treat principle.
Results: A total of 205 women (median age, 32 years; median prepregnancy body mass index, 23.5 kg/m2; median gestational age, 27 weeks) were randomized (102 to adjunctive flash glucose monitoring and 103 to self-monitoring alone). The percentage of self-monitored glucose measurements within target range was lower in the adjunctive flash monitoring group (89.5% vs 92.6%, P=.04). Median fasting and 1-hour postprandial self-monitored glucose concentrations were comparable between groups and within recommended targets. The incidence of large-for-gestational-age infants was lower in the flash monitoring group (3% vs 11%; P=.05; odds ratio, 0.27; 95% confidence interval, 0.07-0.99).
Conclusion: Adjunctive flash glucose monitoring did not improve glycemic outcome in this low-risk gestational diabetes population. However, it was associated with fewer large-for-gestational-age neonates, a secondary outcome that should be interpreted cautiously given the sample size and number of events.
(Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.)
Contributed Indexing: Keywords: continuous glucose monitoring (CGM); flash glucose monitoring (FGM); gestational diabetes (GDM); large-for-gestational-age (LGA); perinatal outcomes; self-monitoring of blood glucose (SMBG); small-for-gestational-age (SGA)
Substance Nomenclature: 0 (Blood Glucose)
Entry Date(s): Date Created: 20260405 Date Completed: 20260717 Latest Revision: 20260824
Update Code: 20260824
DOI: 10.1016/j.ajog.2026.03.030
PMID: 41935728
Βάση Δεδομένων: MEDLINE
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  Data: Flash glucose monitoring addition to self-monitoring of blood glucose and perinatal outcomes in gestational diabetes: a randomized controlled trial.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Zorko+K%22&quot;&gt;Zorko K&lt;/searchLink&gt;; Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Munda+A%22&quot;&gt;Munda A&lt;/searchLink&gt;; Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Janež+A%22&quot;&gt;Janež A&lt;/searchLink&gt;; Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Pongrac+Barlovič+D%22&quot;&gt;Pongrac Barlovič D&lt;/searchLink&gt;; Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. Electronic address: drazenka.pongrac@kclj.si.
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  Data: Background: Self-monitoring of blood glucose represents the standard for glycemic monitoring in gestational diabetes mellitus, while the role of continuous glucose monitoring remains uncertain.&lt;br /&gt;Objective: To assess whether adjunctive flash glucose monitoring improves achievement of established self-monitored glucose targets compared with self-monitoring alone and to examine maternal and neonatal outcomes.&lt;br /&gt;Study Design: We conducted an open-label, single-center, randomized controlled trial comparing adjunctive flash glucose monitoring plus self-monitoring of blood glucose with self-monitoring of blood glucose alone. The prespecified primary outcome was the percentage of self-monitored glucose measurements within the established target range. Secondary outcomes included maternal and neonatal outcomes. Analyses followed the intention-to-treat principle.&lt;br /&gt;Results: A total of 205 women (median age, 32 years; median prepregnancy body mass index, 23.5 kg/m&lt;superscript&gt;2&lt;/superscript&gt;; median gestational age, 27 weeks) were randomized (102 to adjunctive flash glucose monitoring and 103 to self-monitoring alone). The percentage of self-monitored glucose measurements within target range was lower in the adjunctive flash monitoring group (89.5% vs 92.6%, P=.04). Median fasting and 1-hour postprandial self-monitored glucose concentrations were comparable between groups and within recommended targets. The incidence of large-for-gestational-age infants was lower in the flash monitoring group (3% vs 11%; P=.05; odds ratio, 0.27; 95% confidence interval, 0.07-0.99).&lt;br /&gt;Conclusion: Adjunctive flash glucose monitoring did not improve glycemic outcome in this low-risk gestational diabetes population. However, it was associated with fewer large-for-gestational-age neonates, a secondary outcome that should be interpreted cautiously given the sample size and number of events.&lt;br /&gt; (Copyright &#169; 2026 The Authors. Published by Elsevier Inc. All rights reserved.)
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