(277) Satisfaction with continuous glucose monitoring and time in range among individuals with gestational diabetes

Satisfaction with continuous glucose monitoring (CGM) for management of diabetes has been shown to correlate with time in range (TIR) in individuals with Type 1 diabetes. Among individuals with gestational diabetes mellitus (GDM) using CGM, degree of satisfaction with use and correlation of satisfaction with TIR is unknown. We sought to describe satisfaction with CGM use and association with TIR among individuals with GDM.

Study Design:

This was a secondary analysis of pregnant individuals with GDM randomized to CGM versus capillary blood glucose monitoring for GDM management. Participants randomized to CGM completed a 48-item Likert scale CGM satisfaction survey instrument (CGM-SAT). Among individuals with CGM-SAT responses, we examined the association between CGM-SAT scores and TIR, defined as glucose levels 63-140 mg/dL. We examined associations between CGM-SAT scores and screening instrument scores for food security and health literacy.

Results:

Of 111 participants in the trial, 68 individuals were assigned to the CGM arm and provided CGM-SAT responses.  Satisfaction with CGM was high with a mean CGM-SAT score of 3.9 ± 0.6. Mean TIR was also high at 93.0% ± 6.1. Degree of satisfaction did not differ between individuals with TIR ≥90% (n=54), vs TIR <90% (n=14): mean CGM-SAT scores were 4.0 ± 0.5 and 3.7 ± 0.7, respectively (two sample t-test p-value = 0.138). The cohort included individuals experiencing food insecurity (n=8, 11.8%) and with limited health literacy (n=6, 8.8%). Satisfaction did not differ between individuals with food security and adequate health literacy (mean CGM-SAT 3.9 ± 0.5) and individuals with food insecurity and limited health literacy (mean CGM-SAT 3.4 ± 2.1).

Conclusion:

This study demonstrated high satisfaction levels and high mean percent TIR among a cohort assigned to CGM for management of GDM that included few individuals with limited health literacy and food insecurity. No significant correlation was identified between mean CGM-SAT scores and TIR in our population. Large clinical trials are needed to evaluate benefits of and barriers to CGM for management of GDM.