Managing Diabetes in Pregnancy: Why Use Technology?

photograph of the author
Author
Mareda Lewer, MPH
photograph of the reviewer
Medically reviewed by
Lois Donovan, MD FRCPC
Published On
March 5, 2026
Updated On
March 23, 2026

Diabetes management is particularly demanding during pregnancy—for both women and their care teams. A new international expert consensus affirms that continuous glucose monitoring (CGM) and automated insulin delivery (AID) can be safely used in pregnancy, offering much-needed tools to meet this challenge.  Let’s break down how these tools can help.

 

REDUCE RISK OF COMPLICATIONS

T1D

In type 1 diabetes, data shows that using CGM during pregnancy CGM leads to a significantly higher TIRp and reduces risk for LGA infants, neonatal intensive care unit admissions, severe neonatal hypoglycaemia, and hypertensive disorders of pregnancy. CGM has been shown to be cost-saving while improving neonatal outcomes in pregnancies complicated by type 1 diabetes.1–7  As for AID, experts recommend opting for systems with RCT evidence of at least a 5% increase in daily TIRp—as every 5% increase is associated with clinically meaningful benefits to obstetric and neonatal outcomes.8 For detailed information on how to choose or adapt AID systems to optimize TIRp, check out this resource (or Table 2 in the consensus). 

 

T2D

Trials are currently underway to learn more about CGM and AID use during pregnancy with type 2 diabetes. Two existing studies with limited generalizability suggest benefits for glycemic control as observed in type 2 diabetes outside of pregnancy, and suggest consistent CGM use may reduce risk for adverse neonatal outcomes, preterm birth, and NICU admission.9,10  While more research is needed to determine whether CGM is broadly beneficial to support pregnancy outcomes with type 2 diabetes, Panel 2 in the consensus statement provides targets to support individualized use of CGM when accessible and appropriate.

 

GDM

Recent trials suggest that CGM may benefit glycemic management in GDM.11–14 While the impact of CGM on clinically meaningful pregnancy outcomes is still being investigated, individuals with GDM may prefer CGM over traditional finger-stick testing.15 As with T2D, Panel 2 in the consensus statement provides targets to support individualized use of CGM when accessible and appropriate.

 

FEWER FINGERSTICKS

CGMs reduce the need for fingerstick testing, minimizing pain and time burdens for patients while providing more comprehensive glucose data in the process (get the full picture, not a few random time points).

 

FINE-TUNE DIET AND EXERCISE

CGM helps pregnant women see the real-time impact of diet, physical activity, and other factors on their glucose levels. Health behavior modifications are a helpful tool in the management toolbox to meet narrow pregnancy glucose targets. While more research is needed to determine the impacts of CGM on health behaviors during pregnancy, evidence outside of pregnancy suggests CGM may be supportive of positive changes in these behaviors.16–19

 

CHECK IN REMOTELY

The close monitoring and frequent adjustments needed throughout pregnancy impose a significant burden on women with diabetes, particularly those working full time or living in rural areas. Most CGM and AID systems can send data directly to the cloud, allowing you to review someone’s patterns without requiring an in-person visit. These resources provide more information on how your practice can bill for remote monitoring.

 

REDUCE BURDEN

While mental health concerns such as depression and anxiety are common during pregnancy in the general population,20 women with diabetes face even higher risk due to the added burdens of managing a chronic condition so intensively.21,22 Diabetes technologies may help ease some of this burden—reducing stress and fear of hypoglycemia for many.23–27 More research is needed to determine the impact of tech on burden in pregnancy, specifically, but as always recommendations should be tailored to each individual’s needs, taking into account possible effects on sleep and anxiety.28,29 Consider sharing these resources with those in your care to support mental health while using diabetes technology.

 

*Note regarding language: The term ‘women’ is used throughout this guide to avoid misrepresenting research findings and to maintain visibility of unique needs and experiences which may be inadvertently erased by using broader language. The points above also apply to people who do not identify as women, but are pregnant or have given birth, recognizing that inclusivity and consideration of medical and social needs for this group require additional, unique attention. 

 

References

  1. Feig DS, Donovan LE, Corcoy R, et al. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. The Lancet. 2017;390(10110):2347-2359. doi:10.1016/S0140-6736(17)32400-5 
  2. Murphy HR, Feig DS, Sanchez JJ, de Portu S, Sale A. Modelling potential cost savings from use of real‐time continuous glucose monitoring in pregnant women with Type 1 diabetes. Diabet Med. 2019;36(12):1652-1658. doi:10.1111/dme.14046 
  3. Ahmed RJ, Gafni A, Hutton EK, et al. The cost implications of continuous glucose monitoring in pregnant women with type 1 diabetes in 3 Canadian provinces: a posthoc cost analysis of the CONCEPTT trial. CMAJ Open. 2021;9(2):E627-E634. doi:10.9778/cmajo.20200128 
  4. Jones LV, Ray A, Moy FM, Buckley BS. Techniques of monitoring blood glucose during pregnancy for women with pre‐existing diabetes. Cochrane Database Syst Rev. 2019;2019(5):CD009613. doi:10.1002/14651858.CD009613.pub4 
  5. Chang VYX, Tan YL, Ang WHD, Lau Y. Effects of continuous glucose monitoring on maternal and neonatal outcomes in perinatal women with diabetes: A systematic review and meta-analysis of randomized controlled trials. Diabetes Res Clin Pract. 2022;184:109192. doi:10.1016/j.diabres.2022.109192 
  6. Diab YH, Saade G, Kawakita T. Continuous glucose monitoring vs. self-monitoring in pregnant individuals with type 1 diabetes: an economic analysis. Am J Obstet Gynecol MFM. 2024;6(8):101413. doi:10.1016/j.ajogmf.2024.101413 
  7. Sekhon J, Graham D, Mehrotra C, Li I. Continuous glucose monitoring: A cost-effective tool to reduce pre-term birth rates in women with type one diabetes. Aust N Z J Obstet Gynaecol. 2023;63(2):146-153. doi:10.1111/ajo.13581 
  8. Murphy HR. Continuous glucose monitoring targets in type 1 diabetes pregnancy: every 5% time in range matters. Diabetologia. 2019;62(7):1123-1128. doi:10.1007/s00125-019-4904-3 
  9. Padgett CE, Ye Y, Champion ML, et al. Continuous Glucose Monitoring for Management of Type 2 Diabetes and Perinatal Outcomes. Obstet Gynecol. 2024;144(5):677-683. doi:10.1097/AOG.0000000000005609 
  10. McLean A, Barr E, Tabuai G, Murphy HR, Maple-Brown L. Continuous Glucose Monitoring Metrics in High-Risk Pregnant Women with Type 2 Diabetes. Diabetes Technol Ther. 2023;25(12):836-844. doi:10.1089/dia.2023.0300 
  11. Linder T, Dressler-Steinbach I, Wegener S, et al. Glycaemic control and pregnancy outcomes with real-time continuous glucose monitoring in gestational diabetes (GRACE): an open-label, multicentre, multinational, randomised controlled trial. Lancet Diabetes Endocrinol. 2026;14(1):50-61. doi:10.1016/S2213-8587(25)00288-8 
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  13. Burk J, Ross GP, Hernandez TL, Colagiuri S, Sweeting A. Evidence for improved glucose metrics and perinatal outcomes with continuous glucose monitoring compared to self-monitoring in diabetes during pregnancy. Am J Obstet Gynecol. 2025;233(3):162-175. doi:10.1016/j.ajog.2025.04.010 
  14. García-Moreno RM, Benítez-Valderrama P, Barquiel B, et al. Efficacy of continuous glucose monitoring on maternal and neonatal outcomes in gestational diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials. Diabet Med J Br Diabet Assoc. 2022;39(1):e14703. doi:10.1111/dme.14703 
  15. Amylidi-Mohr S, Zennaro G, Schneider S, Raio L, Mosimann B, Surbek D. Continuous glucose monitoring in the management of gestational diabetes in Switzerland (DipGluMo): an open-label, single-centre, randomised, controlled trial. Lancet Diabetes Endocrinol. 2025;13(7):591-599. doi:10.1016/S2213-8587(25)00063-4 
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  17. Martens TW, Willis HJ, Bergenstal RM, Kruger DF, Karslioglu-French E, Steenkamp DW. A Randomized Controlled Trial Using Continuous Glucose Monitoring to Guide Food Choices and Diabetes Self-Care in People with Type 2 Diabetes not Taking Insulin. Diabetes Technol Ther. 2025;27(4):261-270. doi:10.1089/dia.2024.0579 
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  20. Kendig S, Keats JP, Hoffman MC, et al. Consensus Bundle on Maternal Mental Health. Obstet Gynecol. 2017;129(3):422-430. doi:10.1097/AOG.0000000000001902 
  21. Delanerolle G, Phiri P, Zeng Y, et al. A systematic review and meta-analysis of gestational diabetes mellitus and mental health among BAME populations. EClinicalMedicine. 2021;38:101016. doi:10.1016/j.eclinm.2021.101016 
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  24. Gilbert TR, Noar A, Blalock O, Polonsky WH. Change in Hemoglobin A1c and Quality of Life with Real-Time Continuous Glucose Monitoring Use by People with Insulin-Treated Diabetes in the Landmark Study. Diabetes Technol Ther. 2021;23(S1):S35-S39. doi:10.1089/dia.2020.0666 
  25. Nana M, Moore SL, Ang E, Lee ZX, Bondugulapati LNR. Flash glucose monitoring: Impact on markers of glycaemic control and patient-reported outcomes in individuals with type 1 diabetes mellitus in the real-world setting. Diabetes Res Clin Pract. 2019;157. doi:10.1016/j.diabres.2019.107893 
  26. Pickup JC, Ford Holloway M, Samsi K. Real-time continuous glucose monitoring in type 1 diabetes: a qualitative framework analysis of patient narratives. Diabetes Care. 2015;38(4):544-550. doi:10.2337/dc14-1855 
  27. Pinsker JE, Müller L, Constantin A, et al. Real-World Patient-Reported Outcomes and Glycemic Results with Initiation of Control-IQ Technology. Diabetes Technol Ther. 2021;23(2):120-127. doi:10.1089/dia.2020.0388 
  28. Cobry EC, Karami AJ, Meltzer LJ. Friend or Foe: a Narrative Review of the Impact of Diabetes Technology on Sleep. Curr Diab Rep. 2022;22(7):283-290. doi:10.1007/s11892-022-01468-x 
  29. Lin YK, Hepworth E, de Zoysa N, et al. Relationships of hypoglycemia awareness, hypoglycemia beliefs, and continuous glucose monitoring glycemic profiles with anxiety and depression symptoms in adults with type 1 diabetes using continuous glucose monitoring systems. Diabetes Res Clin Pract. 2024;209:111596. doi:10.1016/j.diabres.2024.111596