(LB02-11-25) Impact of Real-Time Continuous Glucose Monitoring on Dietary Quality Among Pregnant Persons With Gestational Diabetes Mellitus

Objectives: Gestational diabetes mellitus (GDM) impacts ~10% of pregnancies in the US. Optimizing care for individuals with GDM is a national priority to improve maternal, fetal, and infant outcomes and to reduce chronic disease risk later in life. Consuming a nutrient-dense, balanced diet is the first line of intervention for individuals with GDM. The aims of this secondary analysis were to determine 1) if having access to CGM data influenced maternal dietary quality among pregnant individuals with GDM randomized to CGM (Dexcom^© G6) or capillary blood glucose monitoring (CBG, Contour® Next Blood) and 2) if glucose time-in-range (GTIR;63-140mg/dL) was different for those who achieved HEI ≥ 64.

Methods: Participants with dietary assessments were included in the analyses (CGM n=52; CBG n=14). Dietary quality was assessed with a single Automated Self-Administered 24-hour Recall collected 4 weeks after enrollment (at ≥ 20 weeks of gestation). Mean nutrient intake values and Healthy Eating Index (HEI) scores were compared between the real-time CGM vs CBG groups using unpaired t-tests, chi-square analysis, and odds ratios.

Results: Mean energy (1910 ± 673 kcal/d vs 1850 ± 714 kcal/d, p=0.77), carbohydrate (37 ± 9.6 % energy intake (EI) vs 41 ± 16 %EI, p=0.24), protein (20 ± 6.0 %EI vs 20 ±6.1 %EI, p=0.79), fat (44 ± 7.7 %EI vs 40 ± 12 %EI, p=0.16), total carbohydrate (179 ± 80.7g/d vs 182 ± 75.7g/d, p=0.90), fiber (19 ± 10 g/d vs 18 ±8  g/d, p=0.66), added sugars (8.7 ± 8.9 g/d vs 9.3 ± 8.6 g/d, p=0.80), micronutrient consumption, and mean HEI scores (54.9 ± 13.8 vs 52.8 ± 11.3, p=0.61) were not statistically different between groups. Participants with HEI scores ≥ 64 were no more likely to achieve a mean percent GTIR ≥ 90% than those with HEI scores < 64 (OR=0.73, 95% CI 0.2, 2.8; p=0.65). 

Conclusions: Individuals with GDM who had access to real-time CGM data had diets of similar quality as those using CBG. Most participants met established recommendations for macronutrients and micronutrients during pregnancy, yet mean HEI scores were below the national average for pregnant women (x̄=63). Those with higher HEI scores were no more likely to achieve greater glycemic control. These data will be useful to plan appropriately powered studies to optimize maternal, fetal, and infant health outcomes in pregnancies affected by GDM.

Funding Sources: Dexcom, Inc (San Diego, CA)