Maternal and neonatal outcomes continue to be deeply impacted by this condition in both the short and long term, contributing to the current obesity and type 2 diabetes (T2DM) pandemic. Gestational Diabetes Mellitus (GDM) is a major public health issue, with steeply increasing incidence in the last decades due to a combination of maternal and environmental factors as well as changes in diagnostic strategies. Further research including larger cohorts of patients, and additional triangulation elements (such as GDM biomarkers/outcomes and expanded m-UGDS) is needed to explore CGM potential for GDM diagnosis. CGM triangulation analysis suggests OGTT screening may result in both false positives and negatives. ConclusionsĬGM represents a more acceptable alternative for GDM diagnosis to the OGTT. Only one woman for each of the last two categories had m-UGDS evaluated, with discordant results. Triangulation identified also six ‘false positive’ women (positive OGTT but TRS and CGM both below the cut-offs). Five women were considered ‘false negative’ (negative OGTT with both TRS and CGMSV above the respective cut-offs). Of the 55 NGT with triangulation data, 28 were considered ‘true negative’ (TRS concordant with OGTT and CGMSV): of these 4/5 evaluated at ultrasound had m-UGDS below the cut-off. Women considered CGM significantly more acceptable than OGTT (81% versus 27% rating 5/5, p < 0.001). No significant difference was found between NGT and GDM in terms of demographics (apart from family history of diabetes mellitus), CGM parameters and perinatal outcomes. Of 107 women recruited, 87 (81%) were included: 74 (85%) with negative OGTT (NGT) and 13 (15%) positive (GDM). In a subgroup, GDM ultrasound features (as modified Ultrasound Gestational Diabetes Score – m-UGDS) were also incorporated. CGM distribution/variability/time in range parameters, combined in a CGM Score of Variability (CGMSV), were triangulated with OGTT results and a risk-factor-based Total Risk Score (TRS). CGM/OGTT acceptability as well as GDM risk factors evaluation occurred via three online surveys. Women wore the CGM device for 7 days at 24–28 weeks, undergoing the OGTT before CGM removal. The aim of this study was to assess the Freestyle Libre Pro 2 acceptability as a diagnostic test for GDM, then triangulating its results with OGTT results as well as risk factors and sonographic features of GDM. Continuous Glucose Monitoring (CGM) is potentially a more acceptable and comprehensive test. The validity of the oral glucose tolerance test (OGTT) for GDM diagnosis has long been questioned, with no suitable substitute reported yet. Gestational Diabetes Mellitus (GDM) incidence and adverse outcomes have increased globally.
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