Continuous Glucose Monitoring in Pregnancy
Topic Status Complete
Continuous glucose monitoring systems for managing diabetes in pregnant women.
Outcome of the appraisal
The case for adopting continuous glucose monitoring in pregnant women with type 1 diabetes is supported by the evidence.
The use of continuous glucose monitoring during pregnancy improves glycaemic control and reduces the incidence of pre-eclampsia in the mother as compared to self-monitoring of blood glucose. Continuous glucose monitoring reduces neonatal hypoglycaemia and the need and duration of neonatal intensive care stay.
Cost modelling estimates that the use of continuous glucose monitoring in type 1 diabetic mothers will lead to cost savings of £1,029 per pregnancy as compared to self-monitoring of blood glucose, with the cost savings largely driven by a reduction in neonatal intensive care requirements.
Why was this topic appraised?
Pregnant women with type 1 diabetes have a greater risk of miscarriage, pre-eclampsia and pre-term labour. Babies born to mothers with type 1 diabetes are more likely to be stillborn or to experience a wide range of medical problems after delivery. Tight control of maternal blood glucose levels during pregnancy is thought to minimise these risks to mother and baby. Continuous glucose monitoring uses a sensor that is placed on the upper arm and worn externally by the user, allowing blood glucose information to be monitored continuously, helping the user and their clinical team to achieve optimal glucose control.
Plain language summary
Health Technology Wales (HTW) assessed a procedure called continuous glucose monitoring to help decide whether it should be available to NHS Wales for pregnant women with type 1 diabetes.
Women with diabetes face increased risks and complications during pregnancy. High blood sugar levels can result in an increased risk of damaging the baby. Currently, blood sugar levels are monitored by finger-prick self-monitoring or by “flash” monitoring, where a sensor has to be read by a scanner before the blood sugar level is known.
Continuous glucose monitoring offers a continuous display of blood sugar levels that can be seen straight away and used to guide treatment. It has the potential to reduce the risks and complications that come with diabetes in pregnancy.
HTW’s Guidance supports using continuous glucose monitoring for pregnant women with type 1 diabetes. The evidence shows that it improves control of blood sugar levels and reduces the complications linked to high blood sugar levels in pregnancy. Because the cost of some complications is avoided, using continuous glucose monitoring is also predicted to save money.