Real-time continuous glucose monitoring (CGM) improved glycemic control and reduced neonatal complications in minority pregnant women with preexisting type 2 diabetes. The study published in Diabetes Spectrum, provided relevant evidence from a randomized trial conducted at Howard University. The study enrolled 26 women under 14 weeks’ gestation. Fourteen women used real-time CGM, and 12 used standard blood glucose monitoring (BGM). All participants were on multiple daily insulin injections and had live singleton pregnancies.

By 34 weeks, women in the CGM group achieved a significant HbA1c reduction (−2.04 ± 1.99%; P = 0.002), whereas the BGM group showed no significant improvement. Neonatal outcomes strongly favored CGM: none of the infants experienced persistent hypoglycemia, NICU admission, or related complications, in contrast to multiple adverse events in the BGM group. CGM users maintained an average TIR of 63.1% with reduced glucose variability.

Obstetric outcomes such as gestational hypertension, preeclampsia, and cesarean section were slightly higher in the CGM group, reflecting the higher proportion of African American participants. Overall, real-time CGM provided better maternal glycemic control and neonatal outcomes compared with BGM. Wider adoption in minority populations and larger multicenter studies are needed to confirm these findings.