Self‐monitoring of Blood Glucose in Pregnant Diabetics

Abstract

Sixty-one pregnant patients with insulin-dependent diabetes mellitus completed a self-monitoring program consisting of five daily blood glucose tests at least twice weekly during the ambulatory periods of their pregnancies. Either a reflectometer method, Eyetone, glucometer--reflectometer, or Haemoglucotest 1-44 test strips were used. Of 1 834 glucose profiles, 45% were optimal, with all blood glucose values between 3.9 and 8.3 mmol/l. The 61 pregnancies were compared with 62 pregnancies where the diabetic control and therapy principles were identical, but where self-monitoring blood glucose methods were not employed. The self-monitoring regime resulted in a significant drop in mean blood glucose levels, from 7.8 +/- 1.3 to 6.4 +/- 1.0 mmol/l, compared with the period before the self-monitoring program was introduced. Furthermore, a decline in the number of diabetes-conditioned extra hospitalizations during pregnancy in the self-test group could be registered.

Glucose Monitoring During Pregnancy

“…With the advent of home reflectance monitors in the late 1970s and early 1980s, self-monitoring of blood glucose (SMBG) was demonstrated to be possible, and perhaps beneficial, in women with gestational diabetes [1, 2]. By 2004, SMBG was widely practiced, with more than 90% of obstetrician/gynecologists recommending that their patients with gestational diabetes check fasting blood glucose (FBG).…”

Monitoring blood glucose control in diabetes mellitus: a systematic review.

“…Goldstein and co-workers 124 started monitoring with patients at different stages of pregnancy, but all were less than 30 weeks pregnant. In the two studies by Jovanovic and co-workers, 125,126 and the studies by Espersen and Klebe 127 and Goldberg and co-workers, 118 monitoring was started in the first trimester. Peacock and co-workers 120 did not give details of the gestational age at the start of monitoring.…”

“…119 The next-largest studies contained 116 118 and 104 patients. 126 Three studies 117,122,127 involved between 60 and 100 patients. Less than 25 patients took part in the remaining four studies.…”

“…Patients in the study by Varner and coworkers 123 used Dextrometers™ (Ames). Four studies 117,124,126,127 did not specify the equipment used.…”

“…Varner 123 inferred compliance from the fact that most patients wished to continue monitoring at the end of the study. Seven studies 119,121,122,[124][125][126][127] did not report measuring patient adherence to the study protocol.…”