Sixteen studies were evaluated regarding blood glucose monitoring and ketone testing in pregnant women and in women with gestational diabetes mellitus.   Six studies report that fasting blood glucose monitoring results in improved glucose control and therefore less risk of poor maternal and neonatal outcomes.   Seven studies report a correlation between postprandial blood glucose values with improved maternal and neonatal outcomes; however, ideal postprandial testing timing is unknown.  Two of three studies regarding ketonemia and ketonuria with poor metabolic control during a diabetic pregnancy report a positive association with lower IQ in offspring.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.