The role of continuous glucose monitoring in the diagnosis and management of gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnancy, traditionally diagnosed using the oral glucose tolerance test (OGTT) and managed via self-monitoring of blood glucose (SMBG). However, both methods have limitations, including poor reproducibility, discomfort, and limited ability to detect glycaemic variability. Continuous glucose monitoring (CGM) offers a promising alternative by providing 24-hour glucose profiles and identifying glycaemic excursions missed by SMBG. CGM shows potential for early detection of subclinical dysglycaemia, improved diagnostic accuracy when combined with clinical risk scores, and improved patient satisfaction. Although randomised controlled trials (RCTs) have reported mixed results regarding perinatal outcomes, CGM is associated with improved glycaemic control, reduced gestational weight gain, and high user acceptability. Nocturnal hyperglycaemia identified by CGM may predict fetal overgrowth. Integration with telemedicine may further personalise care. Further large, robust, RCTs are needed to confirm CGM’s clinical value and guide its broader implementation in GDM.