124-LB: Randomized Trial of Continuous Glucose Monitors for the Care of Pregnant People to Limit Staff Exposure

Abstract

Introduction: During a pandemic, use of remote monitors may reduce close patient contact and decrease risk of occupational exposure. This study evaluated the impact of continuous glucose monitor (CGM) use on the number of close encounters required for diabetes management in pregnant individuals. Methods: This study included 24 pregnant people with pregestational diabetes or medication-controlled gestational diabetes admitted for antepartum care. Participants received a Dexcom G6 CGM and were randomized to clinical use of CGM (intervention) or to standard care with fingerstick point-of-care (POC) glucose checks and a CGM device in blinded mode (control). The primary outcome was the number of POC glucose measurements per nursing shift. Secondary outcomes included glycemic control, neonatal outcomes, and patient and nursing satisfaction measured with surveys. Results: Patients in the intervention group required fewer POC measurements per shift than the control group, but this difference did not reach statistical significance (1.56 ± 0.88 vs 2.28 ± 1.17, p=0.08). Time in the pregnancy-recommended glycemic range (63-140 mg/dL) was similar in both the intervention and the control groups (77.65% ± 22.95 vs. 73.30% ± 27.23, p = 0.89). Time above range (21.64% ± 23.49 vs. 24.84% ± 27.82, p = 0.95) and below range (0.70% ± 1.58 vs. 1.86% ± 4.93, p = 0.64) were also comparable in the intervention and control patients. Neonatal intensive care unit (NICU) admission, neonatal hypoglycemia, hyperbilirubinemia and supplemental oxygen were less likely in the intervention group, however this difference was not significant when adjusted for gestational age at delivery. Patient and nursing satisfaction was high in both groups and not significantly different. Conclusion: Although use of CGM's for antepartum admissions did not significantly decrease close patient contact, equivalent glycemic control was achieved as with standard care. Neonatal outcomes were also similar in both groups. Disclosure J. Grasch: Research Support; Dexcom, Inc., TrueRelief, LLC. N. Nandam: None. E. Buschur: Consultant; Beta Bionics, Inc., Research Support; Dexcom, Inc., JDRF, Leona M. and Harry B. Helmsley Charitable Trust. Funding Dexcom, Inc. (IIS-2020-052)