New Innovation: Use of Flash Glucose Monitoring for Evaluating Glycaemic Variability, Patient Satisfaction and Clinical Utility in Pregnant Women with Diabetes

Aim: Application of Flash glucose monitoring (FGM) system to evaluate glycaemic variability (GV), patient satisfaction and clinical utility in pregnant women with diabetes. Methods: This prospective study was conducted in a tertiary care teaching hospital on 70 pregnant women with diabetes where blood sugar levels were monitored by FGM and self-monitoring of blood glucose (SMBG). Results: FGM generated 19,950 readings versus 1470 readings by SMBG over 3 days. Glucose values measured by FGM and SMBG had significant positive correlation ( r > 0.89; p < 0.001). Significant difference ( p < 0.001) was present between minimum glucose values by FGM (52.49 ± 15.42 mg/dl) and SMBG (72.74 ± 18.30 mg/dl). FGM (20.9%) was able to pick exact duration of hypoglycaemia, while one-third of this duration was missed by conventional SMBG (14.7%; p < 0.05). Hypoglycaemic episodes were observed in 92.9% women by FGM as compared to 45.7% by SMBG ( p < 0.001). No significant difference was observed in maximum glucose level or duration of hyperglycaemia by both methods. FGM identified hyperglycaemia in 74% women vs. 52% by SMBG ( p < 0.001). GV calculated by using MODD by FGM was 118.4 ± 52.4 mg/dl and by SMBG was 83.2 ± 53.2 mg/dl ( p < 0.001). 100% women preferred AGP vs. SMBG. Conclusion: This is the first study to evaluate FGM for GV and patient satisfaction in women with GDM. Significant correlation was observed in glucose values by FGM and SMBG. FGM was more sensitive in detecting GV and hypoglycaemic excursions as compared to SMBG. All women preferred FGM over SMBG. Use of FGM gave new insights in clinical management of challenging cases.