Management of gestational diabetes can be more efficient with the use continuous glucose monitoring (CGM), according to new research presented at the Society for Maternal-Fetal Medicine (SMFM) 2026 Annual Pregnancy Meeting.

CGM has improved care for type 1 diabetes, but its ability to predict outcomes in gestational diabetes has not been well studied, said Amy Valent, DO, MCR, associate professor in the Department of Obstetrics & Gynecology at Oregon Health & Science University in Portland, Oregon, and lead author of the study.

Gestational diabetes affects 10%-14% of all pregnancies, and data suggest that rates are rising, said Emily Fay, MD, associate professor of obstetrics and gynecology at the University of Washington, Seattle, who also helped author the research.

Fay said the study did not definitively answer whether CGMs should always be used for the condition’s management, but they can “give us more blood sugar information, such as time in range and nocturnal hyperglycemia, that is not able to be obtained through self-monitoring of blood glucose through finger sticks,” she said.

Fay and Valent analyzed data from 205 individuals with gestational diabetes across three randomized, controlled trials involving two devices (Dexcom G6 or G6 Pro) to examine the relationship between time spent within the target range for pregnancy (63-140 mg/dL) and composite neonatal outcomes. These included admission to the NICU, transient abnormal rapid breathing, respiratory distress syndrome, birth injury, or hyperbilirubinemia that required phototherapy.

Thirty-two individuals (16%) had newborns who experienced one of the adverse outcomes. Those who spent more time with the healthy range had lower rates of infants with composite outcomes, particularly those who came in under 120 mg/dL.

Each one-category difference in time in target range was associated with an 18% risk reduction of neonatal adverse outcomes (risk ratio [RR], 0.82; 95% CI, 0.69-0.98), with a 21% risk reduction if within the lower range of 63-120 mg/dL (RR, 0.79; 95% CI, 0.64-0.97).

The risk for adverse outcomes was lowest among individuals with a 24-hour mean glucose less than 94 mg/dL.

Risks for adverse outcomes generally increase with increasing blood sugar values, as has been demonstrated by other research, Fay noted. Prospective studies with larger sample sizes are needed to better characterize the relationship between time in range and the outcomes, she said.

Expanding Tech Know-How to Improve Patient Care

CGM and artificial intelligence are more widely used in medicine recently and more patients are asking about their use, said Thinh Nguyen, MD, division chief of perinatal care at Nemours Children’s Health in Orlando, Florida, who was not involved with the study.

“It is important for the medical community to make sure we understand how to best apply and direct care for patients who use CGMs,” Nguyen said.

The study results confirmed prior data and assumptions that good glycemic control reduced the risk for neonatal complications associated with gestational diabetes, Nguyen said.

Many patients find CGM monitoring easier than traditional fingerstick method, which may improve compliance, Nguyen said. In addition, many CGM’s have phone-based apps that allow for automatic data submission to clinicians, which improves communication and enables faster data analysis and timely treatment, he said. In clinical practice, the two most significant barriers to the use of CGM remain cost and insurance coverage, he noted.

The study received no outside funding. The researchers disclosed having no financial conflicts of interest. 

Nguyen disclosed no financial conflicts of interest.