Oral glucose tolerance test and continuous glucose monitoring for gestational diabetes diagnosis: a survey study of women and health care professionals

Abstract

Aims The oral glucose tolerance test (OGTT), used for gestational diabetes mellitus (GDM) diagnosis for over 65 years, has poor acceptability and tolerability. Continuous glucose monitoring is being considered as potential alternative. The aim of our study was to formally assess women’s and health care professionals’ perception of both tests as diagnostic tools for GDM. Methods Participants in a pilot study on continuous glucose monitoring for GDM diagnosis were invited to fill two questionnaires, each of 6 Likert-scale and one optional open-ended question. A range of healthcare practitioners were also invited to fill a questionnaire of 13 Likert-scale and 7 optional open-ended questions. Results Sixty women completed the OGTT and 70 the continuous glucose monitoring questionnaire. OGTT was reported as poorly acceptable. Continuous glucose monitoring was described as significantly more tolerable (81% vs 27% 5/5 general acceptability rate, p < 0.001); ninety-three percent of the participants would recommend it for GDM diagnosis. Thirty health care professionals completed the survey. Most of them (73%) had confidence in OGTT as a diagnostic test for GDM with 66% raising some concerns. Doubts on continuous glucose monitoring were raised in terms of costs, accessibility and accuracy for GDM diagnosis due to “lack of evidence”. Conclusions Continuous glucose monitoring was substantially better tolerated for women than OGTT. Current lack of evidence for diagnostic accuracy for GDM underlines the need for studies on correlation between continuous glucose monitoring parameters and pregnancy outcomes to strengthen evidence for its use as diagnostic test for GDM.

Feasibility and acceptability of continuous glucose monitoring in pregnancy for the diagnosis of gestational diabetes: A single-centre prospective mixed methods study

“…This is in line with results seen by Filippo and colleagues, who used a different methodological approach in pregnant women and healthcare professionals using a customdesigned questionnaire on CGM acceptability [20]. The authors identified that women found CGM to be significantly more acceptable that OGTT and ninety-three percent of the participants would recommend it for diagnosis of gestational diabetes [20]. In our study, all women recommended using CGM.…”

“…CGM offers a novel approach to improve the diagnosis of gestational diabetes and could potentially also improve maternal glycaemic control and pregnancy outcomes. A pilot study performed by Filippo and colleagues suggested that CGM represents a more acceptable alternative for gestational diabetes diagnosis to an OGTT [20] which was confirmed by a subsequent pilot study by the same researchers [21]. However, although preliminary work suggests that CGM can improve maternal glycaemia and reduce offspring birthweight, further studies are needed to confirm the clinical value of CGM in gestational diabetes management [22].…”