Am J Obstet Gynecol. 2026 Apr 2:S0002-9378(26)00180-8. doi: 10.1016/j.ajog.2026.03.030. Online ahead of print.
ABSTRACT
OBJECTIVE: Self-monitoring of blood glucose represents the standard for glycemic monitoring in gestational diabetes mellitus, while the role of continuous glucose monitoring remains uncertain.
METHODS: 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 pre-pregnancy 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=0.04). 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=0.05; OR 0.27, 95% CI 0.07-0.99).
CONCLUSIONS: 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.
PMID:41935728 | DOI:10.1016/j.ajog.2026.03.030
