CGMs in GDM: Evolving Support

Modern medicine has come a long way in its fight against diabetes. We now have continuous glucose monitors (CGM) and automated insulin delivery (AIDs) systems. These have revolutionized patient care. The FDA has approved devices for use in pregnancy as “nonadjunctive use” (meaning they may be used alone), although capillary finger stick assessments are currently still considered the Gold Standard. While the most robust data in support of CGMs is for preexisting Type 1 DM (Class B or beyond) and Type 2, there is recent growing support for CGM use in GDM patients, although some limitations still apply. Listen in for details.1. Feig DS, et al; CONCEPTT Collaborative Group. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet. 2017 Nov 25;390(10110):2347-2359. doi: 10.1016/S0140-6736(17)32400-5. Epub 2017 Sep 15. Erratum in: Lancet. 2017 Nov 25;390(10110):2346. 2. Benhalima K, Durnwald C, Sweeting A et al.Application of continuous glucose monitoring and automated insulin delivery technologies for pregnant women with type 1, type 2, or gestational diabetes: an international consensus statementThe Lancet Diabetes & Endocrinology, 2025; 14, 157-1773. Salmen BM, Reurean-Pintilei D, Salmen T, Bohîlțea RE. Exploring Continuous Glucose Monitoring in Gestational Diabetes: A Systematic Review. Life (Basel). 2025 Aug 28;15(9):1369. doi: 10.3390/life15091369. PMID: 41010309; PMCID: PMC12470761.4. Wyckoff JA, Lapolla A, Asias-Dinh BD, et al.Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism. 20255. American Diabetes Association Professional Practice Committee for Diabetes*; 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2026. Diabetes Care 1 January 2026; 49 (Supplement_1): S321–S338. https://doi.org/10.2337/dc26-S0156. Burk J, Ross GP, Hernandez TL, Colagiuri S, Sweeting A. Evidence for improved glucose metrics and perinatal outcomes with continuous glucose monitoring compared to self-monitoring in diabetes during pregnancy. Am J Obstet Gynecol. 2025 Sep;233(3):162-175. doi: 10.1016/j.ajog.2025.04.010. Epub 2025 Apr 10. PMID: 40216177.7. Linder T, et al; GRACE study collaborative group. Glycaemic control and pregnancy outcomes with real-time continuous glucose monitoring in gestational diabetes (GRACE): an open-label, multicentre, multinational, randomised controlled trial. Lancet Diabetes Endocrinol. 2026 Jan;14(1):50-61. doi: 10.1016/S2213-8587(25)00288-8. Epub 2025 Nov 24. PMID: 41308662.8. Valent AM, et al. Real-Time Continuous Glucose Monitoring in Pregnancies With Gestational Diabetes Mellitus: A Randomized Controlled Trial. Diabetes Care. 2025 Sep 1;48(9):1581-1588. doi: 10.2337/dc25-0115. PMID: 40730104; PMCID: PMC12368369.9. Kusinski LC, et al. Continuous Glucose Monitoring Metrics and Pregnancy Outcomes in Women With Gestational Diabetes Mellitus: A Secondary Analysis of the DiGest Trial. Diabetes Care. 2025 Aug 19:dc250452. doi: 10.2337/dc25-0452. Epub ahead of print. PMID: 40828742; PMCID: PMC7618813.10. García-Moreno RM, et al. Efficacy of continuous glucose monitoring on maternal and neonatal outcomes in gestational diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials. Diabet Med. 2022 Jan;39(1):e14703. doi: 10.1111/dme.14703. Epub 2021 Oct 13. PMID: 34564868.11. Amylidi-Mohr Set,.et al (DipGluMo): an open-label, single-centre, randomised, controlled trial. Lancet Diabetes Endocrinol. 2025 Jul;13(7):591-599. doi: 10.1016/S2213-8587(25)00063-4. Epub 2025 May 26. Erratum in: Lancet Diabetes Endocrinol. 2026 Mar;14(3):e6. doi: 10.1016/S2213-8587(25)00403-6. PMID: 40441173.