Continuous glucose monitoring (CGM) is increasingly used during pregnancy in women with Type 1 diabetes mellitus (T1DM), although real-world outcome data remain limited outside clinical trials. A multicenter cohort study published in Diabetes Technology & Therapeutics evaluated glycemic and pregnancy outcomes associated with CGM use across Australian diabetes centers between 2015 and 2025.

The analysis included 951 pregnant women with T1DM, of whom 456 (48%) used CGM during pregnancy. Baseline demographic and clinical characteristics were similar between CGM users and nonusers. The primary outcome was change in glycated hemoglobin (HbA1c) from the first to the third trimester. Secondary outcomes included trimester-specific HbA1c targets, maternal outcomes, and neonatal health measures.

Findings

• Adjusted linear regression models showed that CGM use was independently associated with a greater reduction in HbA1c during pregnancy compared with nonuse (adjusted mean difference −0.20%; 95% CI −0.40 to 0.00; P=0.037).
• First-trimester HbA1c was the strongest predictor of HbA1c change during pregnancy (P<0.001).
• After adjustment for confounders, CGM use was not associated with differences in large- or small-for-gestational-age outcomes or mean birthweight.
• Among primiparous women, CGM use was associated with lower odds of cesarean delivery (adjusted odds ratio 0.22; 95% CI 0.08-0.58; P=0.002).

The findings suggested that CGM use during pregnancy was associated with improved glycemic control in women with T1DM in routine clinical practice. The magnitude of HbA1c improvement was consistent with results previously reported in the CONCEPTT trial.