Weekly compared with daily blood glucose monitoring in women with diet-treated gestational diabetes.
OBJECTIVE
To estimate whether daily blood glucose self-monitoring reduces macrosomia when compared with weekly office testing in women with gestational diabetes.


METHODS
Between January 1991 and December 1997, standard treatment at our hospital for women with diet-treated gestational diabetes included routine office monitoring of fasting blood glucose. Beginning in January 1998, blood glucose self-monitoring (four times daily) became the standard management. Women with diet-treated gestational diabetes who underwent routine office-based monitoring of fasting glucose values were compared with similar women who used blood glucose self-monitoring. The outcomes of interest were birthweight at or above 4,000 g and large for gestational age (LGA) in relation to the method of blood glucose self-monitoring.


RESULTS
A total of 315 women used daily blood glucose self-monitoring, and they were compared with 675 women with weekly office-based glucose testing. Women with daily blood glucose self-monitoring had fewer macrosomic (29.5% compared with 21.9%, P=.013) and LGA neonates (34.4% compared with 23.1%, P < or = .001) and gained significantly less weight (median 0.56, interquartile range 0.22-1.08 lb per week compared with 0.74, interquartile range 0.33-1.17 lb per week, P=.009).


CONCLUSIONS
Daily blood glucose self-monitoring, compared with weekly office-based testing, is associated with a reduction in the incidence of macrosomia.


METHODS
II.
Hawkins
J Seth
JS
From the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas.
Casey
Brian M
BM
Lo
Julie Y
JY
Moss
Kristie
K
McIntire
Donald D
DD
Leveno
Kenneth J
KJ
D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D016640:Diabetes, Gestational / Q000097:blood* / Q000178:diet therapy*; D005260:Female; D005320:Fetal Macrosomia / Q000517:prevention & control; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy
D001786:Blood Glucose