Summary: In a small single-centre randomised trial of 80 pregnant women with type 2 or gestational diabetes, fasting and 2-hour postprandial glucose fell significantly after an individualised treatment strategy in both the continuous glucose monitoring (CGM) and self-monitored blood glucose (SMBG) arms (P<0.001), with no between-group superiority test reported. Within the CGM arm only, anxiety, pregnancy-related anxiety and diabetes quality-of-life scores improved modestly from before to after the strategy (P<0.05).
PICO Summary
| Element | Detail |
|---|---|
| Population | 80 pregnant women with type 2 diabetes complicating pregnancy or gestational diabetes; single-centre randomised controlled trial, China (ChiCTR2200060719). |
| Intervention | CGM-guided individualised strategy: 14 days of continuous glucose monitoring informing insulin titration plus structured lifestyle modification (CGM arm, approximately n=40). |
| Comparison | Self-monitoring of blood glucose (SMBG) used to guide the same individualised treatment adjustments (SMBG arm, approximately n=40). |
| Outcome | Fasting and 2-hour postprandial glucose decreased significantly after the strategy in both arms (P<0.001); no between-group glycaemic comparison, effect size, 95% CI, ARR or NNT was reported. Within the CGM arm only (before vs after): anxiety SAS 39.59±7.10 to 37.15±6.28, pregnancy-related anxiety PAQ 24.15±6.45 to 22.59±5.65, diabetes quality-of-life DSQL 47.44±9.01 to 43.20±9.00 (all P<0.05). SAS and PAQ scores correlated positively with glucose levels (P<0.05). |
Expert Commentary
This small single-centre randomised trial is best read as exploratory and hypothesis-generating rather than as evidence that CGM is superior to self-monitoring in pregnancy. Glycaemic improvement was driven by the individualised treatment strategy itself, and it occurred in both arms; the headline claim that CGM beats standard care is not supported, because no between-group inferential test for glucose was reported. The psychometric findings were within-arm before-versus-after comparisons in the CGM group only, with no controlled between-group contrast, so they describe an association with the care package rather than a proven effect of monitoring technology. The score changes were also modest and of uncertain clinical relevance. The main limitation is the absence of randomised between-group comparison for the key outcomes, which undercuts any causal reading; the unblinded design and reliance on self-rated scales add further bias. The trial was not described as industry sponsored, and the effect sizes are plausibly small. Can I use this with my patients? Not yet as a reason to switch from structured self-monitoring to CGM. It is reasonable reassurance that intensifying individualised glucose-guided care is feasible and may ease anxiety in motivated patients with diabetes in pregnancy. I would want an adequately powered, randomised between-group trial reporting neonatal and maternal outcomes before changing practice.
References
Liu M, Chen T, Wang S, Li N, Liu D. To assess the impact of individualized strategy and continuous glucose monitoring on glycemic control and mental health in pregnant women with diabetes. Front Endocrinol (Lausanne). 2025;16:1470473. doi:10.3389/fendo.2025.1470473
