Two-weekly self-monitoring of blood glucose okay for monitoring women with lifestyle-controlled gestational diabetes
Malaysia: A recent study published in the International Journal of Gynecology & Obstetrics evaluated 4-point per day self-monitoring of blood glucose (SMBG) every two weeks compared with every week. It found that in lifestyle-controlled gestational diabetes (GDMA1), 2-weekly is noninferior to weekly SMBG on the change in the levels of HbA1c (glycated haemoglobin).
In women with gestational diabetes mellitus (GDM) whose blood sugar is well controlled on a diet alone, the optimum SMBG frequency to control blood sugar is not established. University Malaya Medical Centre advised that SMBG should be less frequent than weekly for GDM patients. Self-monitoring blood glucose by finger-prick blood testing, usually four times daily, is recommended for controlling blood sugar in women with gestational diabetes.
Cheow Teng Thye, Universiti Malaya, Kuala Lumpur, Malaysia, and colleagues aimed to compare one day of four-point blood sugar monitoring every week to 1 day every two weeks, using HbA1c level as the marker of blood sugar control, which is an integrated measure of the average blood glucose level over the last 2-3 months.
The study included 104 patients with lifestyle-controlled gestational diabetes. They were randomized to 2-weekly or weekly 4-point per day (fasting on awakening and 2-h post-meals) SMBG. The primary outcome was the change in HbA1c levels from enrollment to 36 weeks of pregnancy across trial arms. The non-inferiority margin was an HbA1c rise of 0.2%.
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