Self-Monitoring of Blood Glucose in Diabetic Pregnancy

Peacock, Ian; Hunter, James C.; Walford, S; Allison, S; Davison, J.Kenneth; Clarke, P.; Symonds, E. M.; Tattersall, R. B.

doi:10.1097/00006254-198007000-00004

Cited by 3 publications

(4 citation statements)

References 2 publications

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“…No patient in our series had all measurements of capillary blood glucose below this upper limit. The percentage of results above this level was similar to a series where detailed home monitoring of blood glucose was used (Peacock et al, 1979). All our outpatient and in-patient mean blood glucose levels are at least 1 mmol/litre greater than corresponding levels in non-diabetic pregnancy (Stubbs et al, 1980) and much more variable as shown by the greater standard deviations.…”

Section: Discussionsupporting

confidence: 80%

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Maternal blood glucose control and outcome of diabetic pregnancy

Wright

Nicholson

Taylor

et al. 1982

Postgraduate Medical Journal

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SummaryThe results of management of 128 consecutive pregnancies occurring in diabetic patients who received insulin from before conception and throughout pregnancy are described. Mean maternal blood glucose levels were at least 1 mmol/litre greater than levels reported in normal pregnancy. Thirty-nine percent of the neonates had significant morbidity; respiratory distress syndrome (7.7%), hypocalcaemia (464%) and polycythaemia (10%) could be related to higher maternal blood glucose levels. Neonatal hypoglycaemia (9-2%), hyperbilirubinaemia (13.8%) and birth weight corrected for gestational age were not directly related to maternal blood glucose. This degree of maternal blood glucose control has reduced the large for dates infants (greater than 90th centile for gestational age) to 7%. Further reduction in the morbidity of infants of diabetic mothers requires studies of physiological maternal blood glucose levels which may not be possible with conventional insulin treatment as well as further efforts to reduce prematurity.

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Section: Discussionsupporting

confidence: 80%

“…Capillary blood glucose would therefore rarely exceed 7-5 mmol/litre. For comparison in a detailed study (Peacock et al, 1979) of day-to-day monitoring of capillary blood glucose during pregnancy an overall mean level of 7.1 mmol/litre ± 26 s.d. was achieved in 25 diabetic pregnancies with satisfactory outcome.…”

Section: Introductionmentioning

confidence: 99%

Maternal blood glucose control and outcome of diabetic pregnancy

Wright

Nicholson

Taylor

et al. 1982

Postgraduate Medical Journal

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“…We too have achieved a significantly better BG regulation since we adopted the self-test regime (1,5,9,14) (Table 111) and we have had the opportunity to evaluate the effect of this on a regime which otherwise continued without further change. The BG values estimated by the laboratory at the ambulant visits decreased significantly and the number of necessary hospitalizations because of diabetic-related complications during pregnancy fell to approximately 50% without having to increase the number of ambulant check-ups.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus and Pregnancy: A seven‐year material of pregnant diabetics, where control during pregnancy was based on a centralized ambulant regime

Klebe

Espersen

Allen

1986

Acta Obstet Gynecol Scand

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A 7-year survey of the outcome of pregnancy complicated by diabetes mellitus, carried out at the Aarhus center, is presented. The material comprised 344 diabetic pregnant women where the control was based mainly on a centralized ambulant regime. The latter half-period was moreover based on self-monitoring of the blood glucose level. This achieved a significantly better blood glucose regulation, with a reduction of the mean blood glucose level from 7.9 to 6.4 mmol/l. Furthermore, the introduction of self-monitoring halved the number of hospitalizations necessary for blood glucose regulation. Pregnancy was complicated in about 35%. The importance of screening for urinary tract infection is emphasized, since this, which was present in 20% of cases, might be a possible factor in ketoacidosis and/or intra-uterine growth retardation. In 19% of the vaginal births it was deemed necessary to give instrumental assistance; 5% had shoulder dystocia. The cesarean section frequency was 31%. The antenatal mortality rate was 1.2% and the uncorrected perinatal mortality was 3.5%, half of the neonatal mortality was due to fatal congenital malformations. About half of the newborn babies required immediate intensive neonatal treatment. Because of the high frequency of complications in pregnant diabetics, during childbirth and in the neonatal period, centralized monitoring by a highly specialized team is necessary in order to maintain the present relatively low perinatal mortality and morbidity rates and the low number of cesarean sections, together with the most convenient control regimen for this highly pathological group. Furthermore, centralization will facilitate research which, together with prepregnancy consultation, may reduce the frequency of major fetal malformations.

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“…All series published to date (Farquhar 1969;Sack 1969;Karlsson 8c Kjellmer 1972;Gabbe et al 1977;Kitzmiller et al 1978;Adashi et al 1979;Peacock et al 1979;Roversi et al 1980;Skyler et al 1980) show the dramatic reduction of infant morbidity and mortality as treatment programs for the insulin-dependent diabetic woman are established to achieve and maintain normoglycaemia.…”

mentioning

confidence: 99%