{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:58:26Z","timestamp":1791669506167,"version":"4.3.4"},"reference-count":0,"publisher":"American Diabetes Association","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/501100018956","name":"NIHR Cambridge Biomedical Research Centre","doi-asserted-by":"publisher","award":["NIHR203312"],"award-info":[{"award-number":["NIHR203312"]}],"id":[{"id":"10.13039\/501100018956","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004191","name":"Novo Nordisk","doi-asserted-by":"publisher","award":["NNF19SA058974"],"award-info":[{"award-number":["NNF19SA058974"]}],"id":[{"id":"10.13039\/501100004191","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000361","name":"Diabetes UK","doi-asserted-by":"publisher","award":["17\/0005712"],"award-info":[{"award-number":["17\/0005712"]}],"id":[{"id":"10.13039\/501100000361","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000361","name":"Diabetes UK","doi-asserted-by":"publisher","award":["ISRCTN 65152174"],"award-info":[{"award-number":["ISRCTN 65152174"]}],"id":[{"id":"10.13039\/501100000361","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Leicester Biomedical Research Centre (BRC), NIHR Cambridge Biomedical Research Centre"},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001648","name":"European Foundation for the Study of Diabetes","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001648","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Continuous glucose monitoring (CGM) is increasingly used in gestational diabetes mellitus (GDM), but optimal metrics, ranges, and targets in this population are undefined. We assessed associations between CGM metrics and pregnancy outcomes in GDM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>During the DiGest study, 425 women with GDM (diagnosed at median [IQR] 25.1 [18.3\u201327.7] weeks) and BMI \u226525 kg\/m2 received a dietary intervention, with masked Dexcom G6 CGM at 29 (n = 361), 32 (n = 215), and 36 (n = 227) weeks\u2019 gestation. For this secondary analysis, we used logistic regression, receiver operating characteristic curves, and the Youden index to assess associations and predictive ability of CGM metrics, including pregnancy-specific time in range (TIRp) (63\u2013140 mg\/dL [3.5\u20137.8 mmol\/L]) and pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>CGM metrics at 29 weeks were significantly associated with large for gestational age (LGA) and small for gestational age (SGA). Participants achieving mean glucose &amp;lt;110 mg\/dL (6.1 mmol\/L), TIRp \u226590%, or pregnancy-specific time above range (TARp) &amp;lt;10% at 29 weeks had a significantly lower risk of LGA (odds ratio [OR] 0.41 [95% CI 0.22, 0.77], 0.38 [0.20, 0.70], and 0.39 [0.20, 0.73], respectively) and SGA (0.26 [0.08, 0.79], 0.30 [0.10, 0.91], and 0.19 [0.06, 0.62], respectively). TARp &amp;lt;10% and mean nocturnal glucose &amp;lt;110 mg\/dL (6.1 mmol\/L) were associated with a reduced odds of preterm birth (OR 0.40 [0.17, 0.94] and 0.42 [0.19, 0.97], respectively). A stricter range (63\u2013120 mg\/dL [3.5\u20136.7 mmol\/L]) had similar performance overall, but had no single statistically robust TIR\/TAR target across all outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In women with GDM, CGM mean glucose &amp;lt;110 mg\/dL (6.1 mmol\/L), \u226590% TIRp, or &amp;lt;10% TARp using a range of 63\u2013140 mg\/dL (3.5\u20137.8 mmol\/L) at 29 weeks\u2019 gestation was associated with a low risk of suboptimal offspring outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-0452","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T17:14:40Z","timestamp":1755623680000},"update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":9,"title":["Continuous Glucose Monitoring Metrics and Pregnancy Outcomes in Women With Gestational Diabetes Mellitus: A Secondary Analysis of the DiGest Trial"],"prefix":"10.2337","author":[{"given":"Laura C.","family":"Kusinski","sequence":"first","affiliation":[{"name":"1Leicester Diabetes Centre and Leicester NIHR Biomedical Research Centre, University of Leicester, University Hospitals Leicester, Leicester, U.K."},{"name":"2Institute of Metabolic Science-Medical Research Laboratories, University of Cambridge, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nooria","family":"Atta","sequence":"additional","affiliation":[{"name":"2Institute of Metabolic Science-Medical Research Laboratories, University of Cambridge, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle L.","family":"Jones","sequence":"additional","affiliation":[{"name":"2Institute of Metabolic Science-Medical Research Laboratories, University of Cambridge, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Smith","sequence":"additional","affiliation":[{"name":"2Institute of Metabolic Science-Medical Research Laboratories, University of Cambridge, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Cooper","sequence":"additional","affiliation":[{"name":"3MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M.","family":"Oude Griep","sequence":"additional","affiliation":[{"name":"3MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten L.","family":"Rennie","sequence":"additional","affiliation":[{"name":"3MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuella","family":"de Lucia Rolfe","sequence":"additional","affiliation":[{"name":"3MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5489-0614","authenticated-orcid":false,"given":"Helen R.","family":"Murphy","sequence":"additional","affiliation":[{"name":"4University of East Anglia, Bob Champion Building, Norwich Research Park, Norwich, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor M.","family":"Scott","sequence":"additional","affiliation":[{"name":"5Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Sharp","sequence":"additional","affiliation":[{"name":"3MRC Epidemiology Unit, University of Cambridge, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6273-0170","authenticated-orcid":false,"given":"Roy","family":"Taylor","sequence":"additional","affiliation":[{"name":"6Newcastle University, Magnetic Resonance Centre, Campus for Ageing and Vitality, Newcastle upon Tyne, Newcastle, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4176-8329","authenticated-orcid":false,"given":"Claire L.","family":"Meek","sequence":"additional","affiliation":[{"name":"1Leicester Diabetes Centre and Leicester NIHR Biomedical Research Centre, University of Leicester, University Hospitals Leicester, Leicester, U.K."},{"name":"2Institute of Metabolic Science-Medical Research Laboratories, University of Cambridge, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2025,8,19]]},"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc25-0452\/839680\/dc250452.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc25-0452\/839680\/dc250452.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T17:14:41Z","timestamp":1755623681000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/doi\/10.2337\/dc25-0452\/163247\/Continuous-Glucose-Monitoring-Metrics-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,19]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2337\/dc25-0452","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,19]]},"article-number":"dc250452"}}