Gestational Diabetes

GDM: Self-monitoring of Glucose (2001)

Self-monitoring of glucose (Gestational Diabetes Mellitus 2001)

Gestational Diabetes Medical Nutrition Therapy Protocol (2001)

The ADA 2001 Gestational Diabetes MNT Evidence-based guide for practice was originally published in a compact disk (CD) format. This 2001 project was published to the online Evidence Analysis Library for the benefit of ADA members, even though it does not follow the current online format and may be missing some of the components. (The current evidence analysis projects include the following components: question, conclusion, grade, search plan and results, evidence summary, overview table, worksheets, and quality check lists.)

• Assessment
  Gestational Diabetes Mellitus Conclusion Statements: Self-monitoring of Blood Glucose (2001 CD)

  • Conclusion

    Self-monitoring of blood glucose is an essential component of maintaining desirable blood glucose in women with GDM. Studies have shown the best outcomes when both fasting and 1 or 2-hour postprandial blood glucose is monitored several times day and used to modify food intake or meal patterns and physical activity. Goals for blood glucose are fasting: = 95 mg/dl, 1-hour: = 140 mg/dl and 2-hour: = 120 mg/dl. Mean serum glucose levels = 86 mg/dl increase the risk for small for gestational age infants and mean glucose levels = 105 mg/dl increase the risk for macrosomia.

  • Grade: I
    • 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.
  • Evidence Summary: Gestational Diabetes and Hemoglobin A1c Testing (2001 CD)
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Langer O, Langer N, Piper JM, Elliott B, Anyaegbunam A.  Cultural diversity as a factor in self-monitoring blood glucose in gestational diabetes.  J Assoc Acad Min Phys 1995;6:73-77.
      • Langer O, Mazze RS.  Diabetes in pregnancy:  Evaluating self-monitoring performance and glycemic control with memory-based reflectance meters.  Am J Obstet Gynecol 1986;155:635-7. 
      • Metzger BE, Coustan DR.  Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus.  The Organizing Committee.  Diabetes Care 1998;21 Suppl 2:B161-167.
  • Evidence Summary: Gestational Diabetes and Self-Monitoring of Blood Glucose (2001 CD)
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Aberg A, Rydhstroem H, Frid A.  Impaired glucose tolerance associated with adverse pregnancy outcome:  A population-based study in southern Sweden.  Am J Obstet Gynecol 2000;184:77-83.
      • Combs CA, Gunderson E, Kitzmiller JL, Gavin LA, Main EK.  Relationship of fetal macrosomia to maternal postprandial glucose control during pregnancy.  Diabetes Care 1992;15:1251-1257.
      • De Veciana M, Major CA, Morgan MA, Asrat T, Toohey JS, Lien JM, Evans AT.  Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy.  NEJM 1995;333:1237-1241.
      • Homko CJ, Sivan E, Reece EA.  Is self-monitoring of blood glucose necessary in the management of gestational diabetes mellitus?  Diabetes Care 1998;21 Suppl 2:B118-22.
      • Langer O, Levy J, Brustman L, Anyaegbunam A, Merkatz R, Divon M.  Glycemic control in gestational diabetes mellitus - how tight is tight enough:  small for gestational age versus large for gestational age?  Am J Obstet Gynecol 1989;161:646-653.
      • Metzger BE, Coustan DR.  Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus.  The Organizing Committee.  Diabetes Care 1998;21 Suppl 2:B161-167.
      • Parretti E, Mecacci F, Papini M, Cioni R, Carignani L, Mignosa M, La Torre P, Mello G.  Third-trimester maternal glucose levels from diurnal profiles in nondiabetic pregnancies:  correlation with sonographic parameters of fetal growth.  Diabetes Care 2001; 24:1319-1323.
      • Schmidt MI, Duncan BB, Reichelt AJ, Branchtein L, Matos MC, Forti AC, Spichler ER, Pousada JMDC, Teixeira MM, Yamashita T, for the Brazilian Gestational Diabetes Study Group.  Gestational diabetes mellitus diagnosed with a 2-hour 75-g oral glucose tolerance test and adverse pregnancy outcomes.  Diabetes Care 2001;24:1151-1155.