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Daily glucose testing lowers macrosomia risk

Daily self-monitoring of blood sugar levels by pregnant women is effective in reducing the risk of having an infant born with macrosomia.

Daily glucose testing lowers macrosomia risk

Daily self-monitoring of blood sugar levels by pregnant women who have mild gestational diabetes is more effective than weekly office-based testing in reducing the risk of having an infant born with macrosomia.

Gestational diabetes is a complication of pregnancy in which women develop diabetes, which can be mild or severe and result in adverse effects for both mother and child, especially if it is uncontrolled. Many of cases resolve after delivery, but the condition does increase the women's risk of diabetes later in life. Macrosomia is defined as a birth weight greater than 4,000 grams (9 pounds).

The value of this strategy among women with gestational diabetes that requires insulin treatment has been established. However, the use of blood glucose self-monitoring devices in the management of women with diet-treated gestational diabetes remains controversial.

To further investigate, researchers from America compared birth weights before and after four-times daily self-monitoring or hospital-based monitoring was performed. Between 1991 and 1997, a total of 675 women with diet-treated gestational diabetes underwent glucose monitoring during each office visit at 1- to 2-week intervals. Between 1998 and 2001, another 315 women, also with diet-treated gestational diabetes, were given blood glucose meters and instructed to test themselves four times a day before meals.

It was found that the incidence of macrosomia was significantly higher with weekly monitoring than with daily monitoring (29 percent vs 22 percent), as was the incidence of large-for-gestational-age offspring (34 percent vs 23 percent). The difference was still statistically significant after taking into account maternal demographics and gestational age at diagnosis.

Maternal weight gain was also reduced after self-monitoring was introduced, although blood glucose levels were not controlled any better. The researchers concluded that if women with diet-treated gestational diabetes become more involved in glycaemic self-monitoring and receive frequent feedback on the effect of diet choices, they will gain less weight and their infants will have a lower risk of being born with macrosomia.
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