To assess the impact of individualized strategy and continuous glucose monitoring on glycemic control and mental health in pregnant women with diabetes
Mengxue Liu, Tong Chen, Shuai Wang, Na Li, Dan Liu
Abstract
Objective To assess the impact of individualized strategy and continuous glucose monitoring (CGM) on glycemic control and mental health(anxiety, depression, pregnancy-related anxiety and diabetes specific quality of life during pregnancy) in patients with diabetes in pregnancy (DIP). Methods In this study, 80 pregnant women diagnosed with type 2 diabetes mellitus (T2DM) complicated with pregnancy or gestational diabetes mellitus (GDM) were enrolled. Participants were randomly assigned to either CGM group or self-monitoring of blood glucose (SMBG) group. Blood glucose was regularly monitored for 14 days to guide and adjust hypoglycemic treatment (lifestyle or hypoglycemic agents) of the patients in time. Baseline characteristics were collected after enrollment. Self-rating anxiety scale (SAS), self-rating depression scale (SDS), pregnancy-related anxiety questionnaire (PAQ), diabetes specific quality of life scale (DSQL) were used to evaluate the anxiety, depression, pregnancy-related anxiety and quality of life. Glycemic parameters and scale scores were collected before and after individualized strategy. Results FBG and 2hPBG significantly decreased post-intervention in both groups (P<0.001). In the CGM group, the scores of SAS (39.59 ± 7.10 vs 37.15 ± 6.28), PAQ (24.15 ± 6.45 vs 22.59 ± 5.65) and DSQL (47.44 ± 9.01 vs 43.20 ± 9.00) after individualized strategy were significantly lower than those before individualized strategy ( P <0.05). The SAS scale scores and PAQ scale scores were positively correlated with blood glucose levels ( P <0.05). Conclusion The individualized strategy encompasses an insulin titration protocol guided by CGM, coupled with structured lifestyle modifications that address dietary patterns, physical activity and more, combined with short-term glucose monitoring can exert a positive effect on glycemic improvement in the short term and meet the requirements of glycemic control in pregnancy, which has important clinical significance. The combined use of individualized strategy and CGM improves glycemic control and may have protective effects on psychological well-being. Clinical Trial Registration https://www.chictr.org.cn , identifier ChiCTR2200060719.