Two-weekly self-monitoring of blood glucose okay for monitoring women with lifestyle-controlled gestational diabetes

Written By :  Medha Baranwal
Medically Reviewed By :  Dr. Kamal Kant Kohli
Published On 2023-05-22 03:45 GMT   |   Update On 2023-05-22 08:22 GMT
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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.

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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%.

The study revealed the following findings:

  • The mean difference for change in HbA1c from enrollment to 36 weeks was 0.003%, within the 0.2% non-inferiority margin.
  • The change in HbA1c level increased significantly within both trial arms—0.275% ± 0.241% in the 2-weekly arm versus 0.277% ± 0.236% in the weekly arm.
  • Participants randomized to 2-weekly SMBG were significantly less likely to receive anti-glycemic treatment—9.6% versus 28.0% (relative risk 0.34).
  • All secondary outcomes—maternal weight gain, preterm delivery, cesarean delivery, birthweight, and neonatal admission—were not significantly different.

The researchers conclude, "Two-weekly SMBG appeared adequate for monitoring women with lifestyle-controlled gestational diabetes."

Reference:

Thye, C. T., Hamdan, M., Sethi, N., Rajaratnam, R. K., Hong, J., & Tan, P. C. Self-monitoring of blood glucose two-weekly versus weekly in gestational diabetes on nutrition therapy: A randomized trial. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.14861


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Article Source : International Journal of Gynecology & Obstetrics

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