An interventional study of FreeStyle Libre 2, continous glucose monitoring in Diabetes, Gestational, Gastric Bypass Status for Obesity Complicating Pregnancy, Childbirth, or the Puerperium and Pregnancy in Diabetic, sponsored by Region Skane. Recruiting at 1 site in Sweden. Open to female participants aged 18 Years to 50 Years. Per ClinicalTrials.gov, last updated 2025-08-22.
Sponsored by Region Skane · Not applicable, Interventional, and Treatment
The goal of this trial is to compare different means of glucose monitoring in women with gestational diabetes and a history of gastric bypass surgery.
The main question it aims to answer is:
How does continous glucose monitoring impact the treatment and affect pregnancy outcome in these women.
Participants will be randomized to either continous glucose monitoring or regular capillary glucose measurements during the last trimester of their pregnancy. Researchers will compare the glucose measurement outcomes, the glucose lowering treatment given and pregnancy outcomes between groups.
The project aims to investigate gestational diabetes in women with a history of gastric bypass surgery (GBP). The investigators will analyse glucose levels by using continuous glucose measurement (GCM) or capillary glucose measurements and compare mean glucose values, treatment and the pregnancy outcome.
In Sweden the incidence of gestational diabetes is 2-5% of pregnancies, but the frequency varies greatly in different areas and in different ethnicities. The women with gestational diabetes have an increased risk of complications during pregnancy. The most acknowledged complications are large for gestational age infants (LGA), preeclampsia and caesarean section. The infants have a higher need for neonatal intensive care, due to the risk of hypoglycaemia, hypoxia and jaundice postpartum. Treating gestational diabetes and normalizing glucose values have been proven to reduce risks of unfavourable pregnancy outcome.
Gastric bypass surgery is a common treatment for obesity. The frequency of young women with gastric bypass surgery and concomitant gestational diabetes have increased. Many maternity care centres have started to use a 3-7 day screening for gestational diabetes, since the routine oral glucose toleration test (OGTT) is not recommended after GBP. It is previously shown that women with GBP have a decreased risk of GDM and LGA infants. However, there is an increased risk of small for gestational age (SGA). There is a lack of knowledge and guidelines regarding the optimal treatment of gestational diabetes in these women. How the glucose variability affects pregnancy outcome is poorly investigated. At Lund University Hospital, Region Skane, Sweden, the screening procedure used since 2012 for GDM-screening in women with GBP is a 3 day 7-point capillary glucose measurement. Approximately 25% of the pregnant women with GBP is diagnosed with GDM, using this method at Lund University Hospital.
In this project the investigators will randomize women with gestational diabetes and a history of gastric bypass (GDM-GBP) into two different groups in the last trimester of pregnancy. Both groups are given standard medical care, which includes visits to the Specialized Maternity Care Unit and weekly follow up by the diabetologist. The first group is given continuous glucose measurement (FreeStyle Libre3) and the other group is given standard medical care which includes 7-point capillary glucose measurement. With the CGM system it is possible to collect more comprehensive data regarding glucose values and variability. Previous studies have shown that women with gastric bypass surgery have an earlier than normal postprandial glucose excursion and are more prone to later postprandial hypoglycaemia. During this study, the physician as well as the patient can observe the early glucose excursion after meals and measure time in target, time above target and time below target. Large for gestational age and accelerated growth of the infant is supposed to be due to high glucose values and a high proportion of Time above target. The increased risk of SGA infants in these women is hypothesized to be due to a large proportion of time below target. However, this theory is not sufficiently investigated and it is not known if the use of CGM can help to reduce the risk of weight deviation in the infants.
The investigators want to examine if new technique in glucose measurement can contribute to more favourable pregnancy outcome in women with gestational diabetes and a history of GDM. The main question is if the use of CGM affect pregnancy outcome. The secondary outcomes includes glucose variability and the use of different treatment approaches in GDM in this group of women.
877 studies on the registry are indexed under Diabetes, Gestational; 203 are open to participants now.
This study's planned enrollment of 120 is close to the median of 110 across 564 interventional studies indexed under Diabetes, Gestational.
Browse Diabetes, Gestational studies →Region Skane is the lead sponsor of 386 studies on the registry; 122 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Use of FreeStyle Libre 3, with Libre Link app and Glooko app for measurement and review of glucose measurements.
Device: FreeStyle Libre 2, continous glucose monitoring
Standard care, including capillary glucose measurements and Glooko app for review of glucose measurements.
The use of FreeStyle Libre 3 sensors and Libre Link app and Glooko app for analysing glucose control in pregnancy
Adverse Pregnancy Outcome
ANY: Caesarian section (Y/N), instrumental delivery (Y/N), preeclampsia (Y/N), premature birth before week 37 (Y/N), Macrosomia (\>4000g) (Y/N), Large for gestational age infant (Y/N), small for gestational age infant (Y/N), shoulder dystocia (Y/N), neonatal hypoglycemia (Y/N) (\<4 hours after birth: \<1.4 mmol/L; 4 to \<24 hours after birth: \<1.9 mmol/L; 24 to \<48 hours after birth: \<2.8 mmol/L, ≥48 hours after birth: 3.3 mmol/L
Time frame: During delivery and postpartum (measured up to 5 days postpartum)
Glucose values
Mean/median glucose values (mmol/l)
Time frame: Gestational week 28-42
Glucose values
Glucose variability (SD)
Time frame: Gestational week 28-42
Glucose values
% Time in Target (3,5-7,8 mmol/l)
Time frame: Gestational week 28-42
Glucose values
% Time below target
Time frame: Gestational week 28-42
Glucose values
% Time above target
Time frame: Gestational week 28-42
Pharmacological treatment
The use of insulin (Y/N)
Time frame: Gestational week 28-42
Pharmacological treatment
the dose of insulin (IE)
Time frame: Gestational week 28-42
Pharmacological treatment
the use of Metformin (Y/N)
Time frame: Gestational week 28-42
Pharmacological treatment
the dose of metformin (g/day)
Time frame: Gestational week 28-42
Birthweight
birth weight of infant (g)
Time frame: at the day of birth
Week of delivery
gestational week
Time frame: exact day (ie 28+0 to 42+6)
Plan to share: No
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