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Keywords:

  • continuous glucose monitoring;
  • early pregnancy;
  • patient satisfaction;
  • pregestational diabetes

Diabet. Med. 29, 272–277 (2012)

Abstract

Aim  To evaluate self-reported satisfaction and barriers to initiating real-time continuous glucose monitoring in early pregnancy among women with pregestational diabetes.

Methods  Fifty-four women with Type 1 diabetes and 14 women with Type 2 diabetes were offered continuous glucose monitoring for 6 days at median 9 (range 6–14) gestational weeks and were asked to answer a semi-structured questionnaire on patient satisfaction.

Results  Median HbA1c was 49 (range 34–86) mmol/mol) [6.6 (5.3–10.0) %] and duration of diabetes was 12 (0.5–37) years. Continuous glucose monitoring was used for 6 (0.5–7) days, with 43 (65%) women using continuous glucose monitoring for at least 5 days. The women experienced 2.7 (0–12) alarms per 24 h, of which approximately one third was technical alarms and one third disturbed their sleep. Sixteen women (24%) reported discomfort with continuous glucose monitoring during daytime and twelve (18%) during sleep. Many women reported improved diabetes understanding (52%) and would recommend continuous glucose monitoring to others (83%). Twenty-four patients (36%) had continuous glucose monitoring removed earlier than planned ( before the intended 6 days of initial monitoring). Ten women (15%) did not wish to use continuous glucose monitoring again in pregnancy. Main causes behind early removal of continuous glucose monitoring were self-reported skin irritation, technical problems and continuous glucose monitoring inaccuracy. No differences were found in continuous glucose monitoring use, inconvenience or compliance with respect to diabetes type.

Conclusions  The majority of pregnant women with diabetes found real-time continuous glucose monitoring useful and the intervention was equally tolerated regardless of diabetes type. Nevertheless, continuous glucose monitoring was frequently removed earlier than planned, primarily because of skin irritation, technical problems and inaccuracy.