Eight pregnant patients with insulin-dependent juvenile diabetes were persuaded to start self-monitoring of blood glucose between the 10th to the 20th week of gestation. One patient with two children discontinued this effort after a short period. Four patients are still on a regimen of self-monitoring during their pregnancy, and three have delivered normal infants. The latter three patients were all able to achieve almost normal blood glucose levels during the pregnancies. These observations, in addition to those of others, lead to the conclusion that self-monitoring of blood glucose can be an useful tool in the management of diabetes, particularly in pregnant women, who have a high degree of motivation to achieve g o o d C o n t r o l .
The goal of diabetes therapy is to achieve normal blood glucose (BG) levels t o prevent acute and chronic complications. The ascertainment of BG during the day is done using glucometers. There are three major impediments: a) compliance to test for long periods; b) overview of results; c) cost of meter and chemistrips. We have developed systems which help overcome the problem. Treatment by a multidisciplinary team (MDT) including social workers, psychologist and education nurse have increased motivation and the patients perform a mean (+SD) of 2.8 (k2.3) tests/day even in the second year. The development of a computer system (DIACON) enabled a rapid accurate statistical analysis of data on self blood glucose monitoring (SBGM), food intake and insulin dose. The patient feeds the computer the SBGM data and receives histograms and tables presenting the mean kSD of BG levels for the requested periods. The dietician feeds the dietary data which provides a break-up into CHO. fats and proteins as well as the distribution in percentage of CHO intake during the day. The physician formulates his recommendation in accordance with data analysis.Endocrinology, 49 100 Petah Tikva, Israel ing requirements are useful or even obligatory pre-requisites t o help achieve the above:Availability of easy and accurate means of ascertaining blood glucose (BG) levels. The widely used urine glucose determinations have been found to be inadequate to reflect the metabolic status of the diabetic at a given time [ 1-31.
During puberty, growth and circulating SIC increase require normal GH secretion txlt the respective role of GH and sex steroids is still unsettled.This question was adressed by canparing children with low or normal GH secretion &ring PP. 28 children, with PP and similar gonadal activity, were classified into 2 groups according to their GH peak response to AITT : Grcup I > 10 ng/ml, Group I1 < 5 ng/ml. They were carpared to prepubertal hypopituitary cases (Grwp 111). Plasma SmC/IGFI was measured by RIA (m + sem).Group n CA (yr) DA (yr) cm/yr GH peak (ng/ml) SmC (U/ml) I 20 7.1 + 0.5 9.8 20.6 9 + 0.6 24 ~2 . 5 2.01 + 0.17 I1 8 8.2 + 1.1 9.5 + 1.3 6.8 + 0.6 3 50.5 0.71 + 0.14 111 7 11.3 + 1.1 6.9 20.9 1.9 + 0.5 1 + 0.3 0.07 ~0 . 0 1 Ry canparison of II/I it appears thst GH deficiency decreased the mean SmC level (p
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