Self-Monitoring of Blood Glucose: A Complementary Method Beyond the Oral Glucose Tolerance Test to Identify Hyperglycemia During Pregnancy

被引：18

作者：

Ardilouze, Amelie ^{[1
]}

Bouchard, Patricia ^{[2
]}

Hivert, Marie-France ^{[1
,3
,4
]}

Simard, Catherine ^{[2
]}

Allard, Catherine ^{[1
]}

Garant, Marie-Pierre ^{[1
]}

Menard, Julie ^{[1
]}

Ouellet, Annie ^{[1
,5
]}

Houde, Ghislaine ^{[1
,2
]}

Pesant, Marie-Helene ^{[1
,2
]}

Baillargeon, Jean-Patrice ^{[1
,2
]}

Ardilouze, Jean-Luc ^{[1
,2
]}

机构：

[1] CHU Sherbrooke, Res Ctr, Sherbrooke, PQ, Canada

[2] Univ Sherbrooke, Dept Med, Endocrine Div, 3001 12th Ave North, Sherbrooke, PQ J1H 5N4, Canada

[3] Landmark Ctr, Harvard Pilgr Hlth Care Inst, Dept Populat Med, Boston, MA USA

[4] Massachusetts Gen Hosp, Diabet Unit, Boston, MA 02114 USA

[5] Univ Sherbrooke, Dept Obstet & Gynecol, Sherbrooke, PQ, Canada

来源：

CANADIAN JOURNAL OF DIABETES | 2019年 / 43卷 / 08期

关键词：

diagnosis; gestational diabetes mellitus; hyperglycemia; oral glucose tolerance test; pregnancy; self-monitoring of blood glucose; GESTATIONAL DIABETES-MELLITUS; RANDOMIZED-TRIAL; FOLLOW-UP; WOMEN; OUTCOMES; INSULIN; REPRODUCIBILITY; DIAGNOSIS; IMPACT; RISK;

D O I：

10.1016/j.jcjd.2019.02.004

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: To compare: 1) 75 g oral glucose tolerance test (OGTT) and self-monitoring of blood glucose (SMBG) in identifying gestational diabetes mellitus (GDM) and other hyperglycemic statuses in pregnant women; 2) pregnancy outcomes according to glycemic status; and 3) participants' opinions regarding both methods. Methods: A prospective study in women with a 50 g glucose load test >= 7.2 mmol/L at 24 to 28 weeks' gestation and singleton pregnancy. Women underwent OGTT (blinded) at day 1, followed by 7 days of SMBG (4 daily measurements: fasting and 2 h postprandially) without modifying diet or lifestyle. GDM (OGTT+) was diagnosed using the criteria of the International Association of the Diabetes and Pregnancy Study Groups, while pregnancy hyperglycemia (SMBG+) was defined as >= 4/7 glucose values >= 5.3 after fasting or >= 6.7 mmol/L 2 h postprandially for any meal of the day. Equivalent management was provided to women with GDM and/or pregnancy-related hyperglycemia. Results: We divided 103 participants (age: 29.5 +/- 5.0 years; prepregnancy body mass index: 25.3 +/- 5.4 kg/ m(2)) into 4 groups according to test results: OGTT+/SMBG+ (n=12, 11.7%); OGTT+/SMBGe (n=14, 13.6%); OGTTe/SMBG+ (n=9, 8.7%); and OGTT-/SMBG- (n=68, 66.0%). Clinical characteristics and maternal outcomes were statistically similar between groups. Neonatal complication rates were greater in groups with hyperglycemia than in the OGTT-/SMBG- group, notably neonatal hypoglycemia (9/12, 7/14, 5/9 vs. 6/68; p<0.001). Participants reported no convenience difference between methods but would prefer OGTT for a future pregnancy. Conclusions: More than half of the women with OGTT+ were normoglycemic in daily life. Conversely, 11.7% of women with OGTTe had pregnancy hyperglycemia. OGTT+ and/or SMBG+ were equally associated with greater neonatal complications. This study suggests that alongside OGTT, SMBG could improve the care of pregnant women. (C) 2019 Canadian Diabetes Association

引用

页码：627 / 635

页数：9

共 42 条

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