Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes

Moy, Foong Ming; Ray, Amita; Buckley, Brian S; West, Helen

doi:10.1002/14651858.cd009613.pub3

Cited by 21 publications

(10 citation statements)

References 53 publications

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Section: Discussionmentioning

confidence: 99%

“…Data on the cost‐effectiveness of RT‐CGM during pregnancy are scarce . A recent systematic review identified only two studies that directly compared CGM with capillary glucose monitoring , neither of which included cost data. It is noteworthy that in CONCEPTT, the numbers needed to treat with CGM to prevent one neonatal complication were low; six for NICU admissions and large for gestational age, and eight for neonatal hyperglycaemia .…”

Section: Discussionmentioning

confidence: 99%

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Modelling potential cost savings from use of real‐time continuous glucose monitoring in pregnant women with Type 1 diabetes

et al. 2019

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Aim To investigate potential cost savings associated with the use of real‐time continuous glucose monitoring (RT‐CGM) throughout pregnancy in women with Type 1 diabetes. Methods A budget impact model was developed to estimate, from the perspective of National Health Service England, the total costs of managing pregnancy and delivery in women with Type 1 diabetes using self‐monitoring of blood glucose (SMBG) with and without RT‐CGM. It was assumed that the entire modelled cohort (n = 1441) would use RT‐CGM from 10 to 38 weeks’ gestation (7 months). Data on pregnancy and neonatal complication rates and related costs were derived from published literature, national tariffs, and device manufacturers. Results The cost of glucose monitoring was £588 with SMBG alone and £1820 with RT‐CGM. The total annual costs of managing pregnancy and delivery in women with Type 1 diabetes were £23 725 648 with SMBG alone, and £14 165 187 with SMBG and RT‐CGM; indicating potential cost savings of approximately £9 560 461 from using RT‐CGM. The principal drivers of cost savings were the daily cost of neonatal intensive care unit (NICU) admissions (£3743) and the shorter duration of NICU stay (mean 6.6 vs. 9.1 days respectively). Sensitivity analyses showed that RT‐CGM remained cost saving, albeit to lesser extents, across a range of NICU costs and durations of hospital stay, and with varying numbers of daily SMBG measurements. Conclusions Routine use of RT‐CGM by pregnant women with Type 1 diabetes, would result in substantial cost savings, mainly through reductions in NICU admissions and shorter duration of NICU care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Modelling potential cost savings from use of real‐time continuous glucose monitoring in pregnant women with Type 1 diabetes

et al. 2019

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“…Two recent systematic reviews found no evidence to recommend one type of insulin or insulin regimen over another or continuous glucose monitoring over intermittent monitoring 4849. Although the findings from CONCEPTT are encouraging, and despite the advances in CSII and CGM, rates of adverse pregnancy outcomes remain high in women with type 1 diabetes.…”

Section: Insulinmentioning

confidence: 99%

Novel therapies for diabetes mellitus in pregnancy

Feghali

Scifres

2018

BMJ

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Diabetes is a common complication of pregnancy, and the prevalence of all types of the disease is increasing worldwide. Diabetes in pregnancy is associated with short term and long term adverse effects for mother and child. The goal of treatment of diabetes in pregnancy is to minimize maternal and fetal adverse events related to hyperglycemia. Treatment options vary by type of diabetes, from a focus on lifestyle modifications in gestational diabetes to continuous glucose monitoring and insulin pumps in pregestational diabetes. Nevertheless, given the commonality of hyperglycemia, considerable overlap exists in the treatment of different types of diabetes in pregnancy. Also, despite ongoing research on treatment of diabetes in pregnancy for decades, changes in the characteristics of the patient population have highlighted the limited effectiveness of different therapies. Specifically, despite the co-occurrence of obesity and diabetes, treatment recommendations including glycemic targets are not altered in such cases and a single optimal treatment strategy for each type of diabetes in pregnancy does not seem to exist. Rather, the approach to treating pregnant women with diabetes likely needs to be individualized to maximize the short term and long term health of mother and child. This article will review recent clinical studies to summarize established treatment strategies and introduce novel therapies for diabetes in pregnancy.

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“…CGM was compared to intermittent monitoring in two studies (225 women), and there was no difference for preeclampsia and cesarean section and large for gestational age. One trial (25 women) compared constant CGM versus intermittent CGM and found no clear difference between groups for cesarean section, glycemic control, or preterm birth [67].…”

Section: Glucose Monitoringmentioning

confidence: 99%

Treatment of Gestational Diabetes

Maged¹

2020

Gestational Diabetes Mellitus - An Overview With Some Recent Advances

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Management of gestational diabetes mellitus (GDM) should consider both the maternal, fetal, and neonatal effects of the disease, line of treatment, and physiological changes during pregnancy. Women with GDM are classified into two categories according to their fasting blood glucose levels. Dietary control is mandatory in both classes, and the addition of pharmacological agents in those with fasting and 2-h postprandial plasma glucose levels <95 and 120 mg/dL is controversial (American College of Obstetricians and Gynecologists, 2013). Individualization of the diet in GDM according to women weight and height is recommended by the American Diabetes Association (ADA), and restriction of carbohydrate to a level that maintains normal glucose level is mandatory with individualization of the caloric intake according to women BMI and weight gain during pregnancy.

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Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes

Abstract: Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes.

Cited by 21 publications

References 53 publications

Modelling potential cost savings from use of real‐time continuous glucose monitoring in pregnant women with Type 1 diabetes

Modelling potential cost savings from use of real‐time continuous glucose monitoring in pregnant women with Type 1 diabetes

Novel therapies for diabetes mellitus in pregnancy

Treatment of Gestational Diabetes

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