Continuous glucose monitoring in gestational diabetes

Gestational diabetes affects between 7·1–27·6% of pregnancies, depending on the global region. Management effectively reduces complications in both early and late pregnancy and includes education, lifestyle change, self-monitoring of blood glucose (SMBG), and medication if glycaemia is above target. Optimal glucose targets remain unclear, but current evidence is based on testing at least four times a day (fasting and 2-h postprandial). Tight glycaemic targets help to protect the fetus, which appears exquisitely sensitive to minor perturbations in maternal glucose: even a maintained fasting glucose of 5·3 mmol/L is associated with a doubling of risk of large for gestational age infants and other pregnancy complications.