Gestational diabetes: Impact of home glucose monitoring on neonatal birth weight

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Abstract

Two groups of 58 gestational diabetic women matched for age, prepregnancy weight, height, and parity were studied. The home glucose monitoring study group performed fasting and 1-hour postprandial capillary blood glucose testing after every meal. The control group was followed by conventional treatment. The incidence of macrosomia (birth weight of ≥4000 gm) and large (≥90%) for gestational age infants was significantly reduced in the home glucose monitoring group. The mean birth weight of the study group was 3231 ± 561 gm, while that of the control group was 3597 ± 721 gm (p < 0.002). Significantly more patients in the home glucose monitoring group were receiving insulin therapy (50% versus 21%). We believe that intensive home glucose monitoring will allow for the early identification of those gestational diabetic patients needing insulin and thus reduce the incidence of macrosomia and large for gestational age infants.

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    Citation Excerpt :

    Most of the few controlled trials were performed in the 1980s, in patients with type 1 diabetes. All four studies found no better neonatal outcomes in the group using SMBG [23–25], or observed no difference between groups performing SMBG at home versus hospital care [26]. One more recent randomised controlled trial in gestational diabetes compared insulin treatment protocols with targets based on fasting versus postprandial glucose levels [27].

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These studies were supported in part by National Institutes of Health Grant HD 11583 and the Sosnoff Foundation.

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