CGM for the Early Detection and Management of Hyperglycemia in Pregnancy

Exclusion Criteria

• •4. HbA1c \<6.5% (48 mmol/mol) since onset of pregnancy
• •• If HbA1c result not available at time of enrollment, participant can have blinded screening CGM initiated, but results will be needed prior to randomization to verify eligibility.
• •5. No prior history of gestational diabetes mellitus (GDM)
• •6. Able to read English or Spanish
• •1. Signs of abnormal fetal or placental development (suspected fetal anomaly or placenta accreta spectrum, low PAPPA) at first routine prenatal visit/ultrasound
• •2. Planned termination of pregnancy or any indications of miscarriage
• •3. Prior gastric bypass surgery
• •4. Pregravid diabetes (type 1 or type 2)
• •5. Unwillingness/inability to wear CGM sensor
• •6. Unwillingness to attend routine antenatal obstetric appointments
• •7. Use of corticosteroids by a route that can produce hyperglycemia (e.g., oral, intravenous, intramuscular, intra-articular) during the 7 days prior to initiating CGM screening or during the CGM screening
• •• Topical and inhaled corticosteroids are acceptable
• •8. Use of insulin during the pregnancy prior to enrollment
• •9. Use of metformin within one week of the initiation of the blinded CGM sensor for screening or use of a GLP-1 or other weight-reduction medication that can affect glucose levels within 4 weeks of the initiation of the blinded CGM sensor for screening
• •10. Deemed unable to participate for medical reasons identified by their physician
• •Additional Criteria for RCT Eligibility
• •1. Screening CGM meeting study criteria for hyperglycemia: 5% to \<25% time \>140 mg/dL
• •2. Randomization by 16 week 6 days of pregnancy
• •3. No participation in a separate intervention trial.