Blood glucose monitoring in gestational diabetes mellitus: 1- versus 2-h blood glucose determinations

Abstract

Gestational diabetes mellitus is a common disorder of pregnancy affecting 3-5% of pregnant women. Although significant controversy exists regarding its diagnosis and treatment, macrosomia has been consistently associated with maternal hyperglycemia. Numerous studies have addressed different approaches to monitoring blood glucose levels, but data on the ideal timing for postprandial determinations are scarce. This article reviews current recommendations and recent findings on the implications of 1- versus 2-h blood glucose determinations in pregnant women with gestational diabetes mellitus. Preliminary studies have shown a statistically significant reduction in macrosomia and decreased need for emergency Cesarean section among women monitored 1 h after meals. Until larger studies confirm these benefits, compliance is of the utmost importance for successful treatment. Therefore, patient preferences should be considered in planning a monitoring strategy.

Frequency and risk factors for recurrent gestational diabetes mellitus in primiparous women: a case control study

“…Our findings were in agreement with previous studies [14, 19] which observed a positive association of high postprandial 1-h glucose value in the first pregnancy with GDM recurrence. Additionally, postprandial 1-h glucose can serve as a better predictor for development of type 2 diabetes mellitus (T2DM) compared with 2-h glucose [22, 23]. A probable reason is that the ability to utilize excess glucose in recurrent GDM patients decreases more severely than in primary GDM patients, which is similar to a study [23] that found that higher 1-h glucose indicated the existence of severe IR.…”

Gestational diabetes mellitus: Non-insulin management

“…in a review reported that patients’ management based on glucose levels measured an hour after meals led to better perinatal outcomes than when patients were managed based upon glucose level measurement 2 hours after meals, in terms of less neonatal hypoglycemia, less macrosomia and fewer cesarean deliveries. [14]…”

Διερεύνηση Του Μεταβολισμού Των Υδατανθράκων Κατά Τη Διάρκεια Του Τοκετού Σε Γυναίκες Με Σακχαρώδη Διαβήτη Κατά Την Κύηση

“…ηελ πεξίπησζε πνπ εληνπίδνληαη κε επηζπκεηέο δηαθπκάλζεηο, πξνηείλνληαη θαη πηνζεηνχληαη αλαπξνζαξκνγέο ζηε δίαηηα, ηελ άζθεζε ή ηελ ηλζνπιηλνζεξαπεία (Clarke, 1987;Mastortotoro, 1998;ADA, 1999 (Goldberg, 2004), αζζελείο ζε κεγάιν θίλδπλν εκθάληζεο ππνγιπθαηκίαο (Chee 2003;Beardsall 2005) ή ππεξγιπθαηκίαο (Goldberg, 2004;Javid, 2005), θαη αζζελείο κε λνζήκαηα απνζήθεπζεο γιπθνγφλνπ (Hershkovitz, 2001) (Bode, 1999;Kaufman, 2001;Salardi, 2002;Schaepelynck -Bélicar, 2003;Garg, 2004;Garg, 2006 [1];Bailey, 2007;DirecNet, 2007; Σέινο, αμίδεη λα αλαθεξζεί ε ζπνπδαηφηεηα ηεο επηινγήο ησλ θαηάιιεισλ αζζελψλππνςεθίσλ γηα ηελ αμηνπνίεζε ησλ ΚΓ (Bailey, 2007;Hirsch, 2007;Mitka, 2007 (Yogev, 2003 [1]; Kestilä, 2007) είλαη έθδειε, φηαλ πξφθεηηαη λα θαζνξηζηεί ε ζεξαπεία κε ηλζνπιίλε ζε έγθπεο κε Γ 1, θαη γεληθεχεηαη ζε έγθπεο κε ΓΚ Yogev, 2003 [1] (Combs, 1992;Huddleston, 1993), ελψ θάπνηνη άιινη ηα 120 min κεηά ην γεχκα (Moses, 1999). ε κηα κειέηε, νη γπλαίθεο κπνξνχζαλ λα επηιέμνπλ ειεχζεξα ην πην βνιηθφ δηάζηεκα γη΄ απηέο (Leguizamon, 2002), ελψ ζε έλα πξσηφθνιιν πξνηάζεθαλ ηα 60 min κεηά ηα κηθξά γεχκαηα θαη ηα 120 κεηά ηα κεγάια, κε ην ζθεπηηθφ ηεο απζηεξφηεξεο παξαθνινχζεζεο ηνπ γιπθαηκηθνχ profile (Sivan, 2001 (Crowther, 2005;Kinsley, 2007).…”

“…Δθηφο απφ ηελ αμηνιφγεζε ηεο αθξίβεηαο, νη θιηληθέο κειέηεο πνπ πεξηιακβάλνληαη ζηελ παξνχζα αλαζθφπεζε, αλέδεημαλ ηελ δπλαηφηεηα ηεο ΚΓ λα ππνδεηθλχεη ηηο πςειέο κεηαγεπκαηηθέο ζπγθεληξψζεηο γιπθφδεο θαη ηα αζπκπησκαηηθά επεηζφδηα λπθηεξηλήο ππνγιπθαηκίαο ζε έγθπεο γπλαίθεο κε Γ 1 θαη ΓΚ, ηδηαίηεξα δε ζε εθείλεο πνπ ιακβάλνπλ ηλζνπιηλνζεξαπεία (Bühling, 2004;Cypryk, 2006 -Peterson, 1991;Combs, 1992;Huddleston, 1993;Moses, 1999;ACOG, 2001;Leguizamon, 2002;Sivan, 2001). ε ηέζζεξηο κειέηεο φπνπ εθαξκφζηεθε ε ΚΓ έγηλε πξνζπάζεηα θαζνξηζκνχ ηνπ ηδαληθνχ ρξφλνπ γηα ηε κεηαγεπκαηηθή κέηξεζε ηεο γιπθφδεο ζε επηπιεγκέλεο κε Γ θπήζεηο: νη ρξφλνη πνπ πξνηάζεθαλ ήηαλ ηα 51 (Kestilä, 2007), 60 (Bühling, 2005), 70 (Yogev, 2004[2]) θαη 90 min (Ben -Haroush, 2004) κεηά ην γεχκα.…”