THE IMPORTANCE OF CONTINUOUS GLUCOSE MONITORING AND DIETARY DECISIONS IN GESTATIONAL DIABETES MELLITUS

Authors

  • Catalina Georgiana TUDOR Cuza-Voda Clinical Hospital of Obstetrics and Gynecology, Iasi
  • D. V. TIMOFTE Grigore Popa University of Medicine and Pharmacy Iasi
  • D. URECHE Vasile Alecsandri University of Bacau
  • Ramona-Alexandra CIAUSU Alexandru Ioan Cuza University of Iasi / Doctoral School of Geosciences
  • M. N. NICOARA Alexandru Ioan Cuza University of Iasi / Doctoral School of Geosciences
  • T. CIOBOTARIU Grigore Popa University of Medicine and Pharmacy Iasi
  • Anastasia-Melania MIHALACHE Grigore Popa University of Medicine and Pharmacy Iasi
  • V. POROCH Grigore Popa University of Medicine and Pharmacy Iasi
  • R. C. TIUTIUCA Grigore Popa University of Medicine and Pharmacy Iasi
  • B. DOROFTEI Cuza-Voda Clinical Hospital of Obstetrics and Gynecology, Iasi

DOI:

https://doi.org/10.22551/MSJ.2025.04.04

Abstract

Gestational diabetes mellitus (GDM) poses significant risks to both the mother and fetus if not managed appropriately. Continuous glucose monitoring (CGM) provides comprehensive glycemic profiles that support individualized dietary interventions. Materials and methods: We discuss here about 44 pregnant women diagnosed with GDM, illustrating how CGM data can be used to optimize glycemic control through specific nutritional strategies. Continuous interstitial glucose measurements were obtained using the Dexcom ONE+ CGM sensor, with monitoring initiated at 27-28 weeks and continued through 39 weeks of gestation. Results: Fasting blood glucose averaged 112 mg/dL. One-hour postprandial glucose differed by meal type (ANOVA, p<0.001), with high-carbohydrate meals producing the highest values, followed by fruits, protein/low-carb meals and snacks (Tukey post-hoc). Two-hour postprandial glucose showed a similar pattern (ANOVA, p<.001). Differences between CGM readings and true glucose levels were larger in participants who experienced false low-glucose alarms, and this difference was statistically significant (t-test, p<0.001). Conclusions: Our data highlights the value of integrating CGM technology with personalized nutritional plans in the effective management of GDM.

Author Biographies

  • Catalina Georgiana TUDOR, Cuza-Voda Clinical Hospital of Obstetrics and Gynecology, Iasi

    Grigore T. Popa University of Medicine and Pharmacy Iasi

  • D. V. TIMOFTE, Grigore Popa University of Medicine and Pharmacy Iasi

    Sf. Spiridon County Clinical Hospital Emergency, Iasi

  • B. DOROFTEI, Cuza-Voda Clinical Hospital of Obstetrics and Gynecology, Iasi

    Grigore T. Popa University of Medicine and Pharmacy Iasi
    Origyn Fertility Center, Iasi

References

1. ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol 2018; 131(2): e49-e64 / doi: 10.1097/AOG.0000000000002501.

2. Najmi A, Atal S, Sadasivam B, Singh P, Ray A. Early onset gestational diabetes mellitus: A case report and importance of early screening. J Family Med Prim Care 2019; 8(5): 1772-1774 / doi: 10.4103/ jfmpc. jfmpc_290_19.

3. Quintanilla Rodriguez BS, Vadakekut ES, Mahdy H. Gestational Diabetes. [Updated 2024 Jul 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545196/.

4. Sweeting A, Wong J, Murphy HR, Ross GP. A Clinical Update on Gestational Diabetes Mellitus. Endocr Rev 2022; 43(5): 763-793 / doi: 10.1210/endrev/bnac003.

5. Szmuilowicz ED, Josefson JL, Metzger BE. Gestational Diabetes Mellitus. Endocrinol Metab Clin North Am 2019; 48(3): 479-493 / doi: 10.1016/j.ecl.2019.05.001.

6. American Diabetes Association. 15. Management of Diabetes in Pregnancy: Standards of Medical Care-2024. Diabetes Care 2024; 46(Suppl 1): S282-S294.

7. Chehab RF, Ferrara A, Greenberg MB, et al. Glycemic control trajectories and risk of perinatal com-plications among individuals with gestational diabetes. JAMA Netw Open 2022; 5(9): e2233955.

8. Cosson E, Baz B, Gary F, et al. Poor reliability and poor adherence to self-monitoring of blood glucose are common in women with gestational diabetes mellitus and may be associated with poor pregnancy outcomes. Diabetes Care 2017; 40(9): 1181-1186.

9. Karter AJ, Ackerson LM, Darbinian JA, et al. Self-monitoring of blood glucose levels and glycemic control: The Northern California Kaiser Permanente Diabetes registry. Am J Med 2001; 111(1): 1-9.

10. Siddiqui MH, Khan IA, Moyeen F, et al. Identifying barriers to therapeutic adherence in Type 2 diabetes: a complex and multidimensional clinical issue. Asp Biomed Clin Case Rep 2019; 2(1): 22-28.

11. Castorino K, Durnwald C, Ehrenberg S, et al. Continuous Glucose Monitoring for Gestational Diabetes Management Working Group. Practical Considerations for Using Continuous Glucose Monitoring in Patients with Gestational Diabetes Mellitus. J Womens Health (Larchmt) 2025; 34(1): 10-20 / doi: 10.1089/jwh.2023.0864.

12. Dexcom, Inc. Dexcom launches Dexcom ONE+ bringing powerful, new diabetes management tech-nology to more people [Internet]. San Diego (CA): Dexcom, Inc.; 2024 Feb 6 [cited 2025 Aug 19]. Available from: https://investors.dexcom.com/news/news-details/2024/Dexcom-Launches-Dexcom-One-Bringing-Powerful-New-Diabetes-Management-Technology-to-More-People/default.aspx.

13. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Geneva: World Health Organization; 2000 (WHO technical report series; 894).

14. Gunderson EP. Gestational diabetes and nutritional recommendations. Curr Diab Rep 2004; 4(5): 377-86 / doi: 10.1007/s11892-004-0041-5.

15. Hernandez TL, Anderson MA, Chartier-Logan C, Friedman JE, Barbour LA. Strategies in the nutri-tional management of gestational diabetes. Clin Obstet Gynecol 2013; 56(4): 803-815 / doi: 10.1097/ GRF.0b013e3182a8e0e5.

16. Dingena CF, Arofikina D, Campbell MD, Holmes MJ, Scott EM, Zulyniak MA. Nutritional and Exercise-Focused Lifestyle Interventions and Glycemic Control in Women with Diabetes in Pregnancy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Nutrients 2023; 15(2): 323 / doi: 10.3390/nu15020323.

17. Jones D, Kyriakidou A, Cooper L, et al. The effect of high-fiber diets on glycemic control in women with diabetes in pregnancy: A systematic review and meta-analysis. Diabet Med 2025; 42(1): e15435 / doi: 10.1111/dme.15435.

18. Beck RW, Riddlesworth T, Ruedy K, et al. DIAMOND Study Group. Effect of Continuous Glucose Monitoring on Glycemic Control in Adults with Type 1 Diabetes Using Insulin Injections: The DIA-MOND Randomized Clinical Trial. JAMA 2017; 317(4): 371-378 / doi: 10.1001/jama.2016.19975.

19. Majewska A, Stanirowski PJ, Wielgoś M, Bomba-Opoń D. Efficacy of Continuous Glucose Monitor-ing on Glycaemic Control in Pregnant Women with Gestational Diabetes Mellitus-A Systematic Re-view. J Clin Med 2022; 11(10): 2932 / doi: 10.3390/jcm11102932.

20. Trofin FP, Chirazi M, Honceriu, et al. Pre-administration of vitamin C reduces-induced oxidative stress status in untrained subjects. Archives of Biological Sciences Belgr 2014; 66(3): 1179-1185.

21. Phalle A, Gokhale D. Navigating next-gen nutrition care using artificial intelligence-assisted dietary assessment tools-a scoping review of potential applications. Front Nutr 2025; 12: 1518466 / doi: 10.3389/fnut.2025.1518466.

22. Trofin P, Coteata M, Honceriu C, Ciobica A, Puni R. Evolution of the correlation between body mass index (BMI) and agility of primary school students in North-Eastern Romania. BRAIN Broad Res Artif Intell Neurosci 2024; 15(3): 78-94 / doi: 10.70594/brain/15.3/5.

Additional Files

Published

2025-12-19

Issue

Vol. 129 No. 4 (2025): The Medical-Surgical Journal

Section

INTERNAL MEDICINE - PEDIATRICS

License

Copyright (c) 2025 The Medical-Surgical Journal

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

COPYRIGHT 
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.

COPYRIGHT TRANSFER FORM FOR 

REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /

THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI

We, the undersigned authors of the manuscript entitled

_____________________________________________________________________________________

_____________________________________________________________________________________

warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.

  1. we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
  2. the manuscript does not break the intellectual property rights of any other person.
  3. we have read the submitted version of the manuscript and we are fully responsible for the content.

Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):

  1. ______________________________/_________________________
  2. ______________________________/_________________________
  3. ______________________________/_________________________

N.B.  All the authors must sign this form