Feasibility of FreeStyle Libre Flash Glucose Monitoring System in pregnant woman affected by type 1 diabetes

Excerpt

Pregnant patients affected by type 1 diabetes (T1DM) are at increased risk for maternal and fetal risk, including congenital malformations, preeclampsia, macrosomia, spontaneous abortion, and perinatal mortality [1]. Tight glycemic control is required to reduce the occurrence of diabetes related pregnancy complications. The more stringent glucose targets and the wide variability in insulin requirement during pregnancy may predispose to hypoglycemic events, and severe hypoglycemia occurs in up to 50% of pregnancies women with T1DM [1, 2]. The National Institute for Health and Care Excellence recommends that blood glucose levels are tested up to eight times daily to achieve glycemic targets [2]. However, many patients experience barriers to frequent testing, including pain and discomfort associated with the multiple finger-stick blood samples. Continuous glucose monitoring (CGM) may improve quality of life in T1DM patients, providing a good accuracy without the pain and the inconvenience of regular finger pricking. Nevertheless, the evidence to support the CGM use in T1DM pregnant women is limited and conflicting [3]. The FreeStyle Libre Flash Glucose Monitoring System (Abbott Diabetes Care, Witney, UK) provides comprehensive glucose data by measuring the glucose concentration in the interstitial fluid, without the need for calibration. Sensor measurements may replace the self-monitoring blood glucose (SMBG) testing, and each device may be worn for up to 14 days. The FreeStyle Libre System improves outcome and quality of life in T1DM patients [4], however it is approved with a restriction of the use during pregnancy. Only a study assessed accuracy and safety of FreeStyle Libre System in pregnant women with T1DM [5]. We report a case of pregnant woman affected by T1DM in which feasibility of FreeStyle Libre System is tested. …