EAL

GDM: Self-monitoring of Glucose (2001)

Citation:

Study Design:

Class:

- Click here for explanation of classification scheme.

Quality Rating:

Research Purpose:

This article reviews the existing evidence in the literature regarding the impact of self-monitoring of blood glucose on outcomes in pregnancies complicated by gestational diabetes.

Inclusion Criteria:

Article inclusion criteria not described.

Exclusion Criteria:

Article exclusion criteria not described.

Description of Study Protocol:

Recruitment

Search strategies not described.

Design: Narrative Review

Blinding used (if applicable): Not applicable

Intervention (if applicable): Not applicable

Statistical Analysis

Statistical analysis not completed.

Data Collection Summary:

Timing of Measurements: not applicable

Dependent Variables: not applicable

Independent Variables: not applicable

Control Variables: not applicable

Description of Actual Data Sample:

Initial N: 38 references included

Attrition (final N): 38

Age: not mentioned

Ethnicity: not mentioned

Other relevant demographics:

Anthropometrics:

Location: worldwide studies

Summary of Results:

Other Findings

At the Third International Workshop Conference it was noted that "self-monitoring of capillary blood glucose has been useful in allowing the woman to participate in her own management, but its utility in the mild GDM not requiring insulin, although reasonable and logical, has not been formally proved."

SMBG improves outcomes in pregnancies complicated by GDM, specifically in regard to reducing the incidence of macrosomia, need for cesarean section, and birth trauma.

For women with preexisting diabetes or at least more severe degrees of glucose intolerance requiring insulin therapy, postprandial glucose levels are more predictive of outcome.

Author Conclusion:

SMBG provides important information for guiding and assessing dietary and insulin therapy for pregnancies complicated by GDM. Furthermore, it enhances patient education, facilitates lifestyle modifications, and allows women to actively participate in their own care. SMBG has been shown to improve neonatal outcomes in pregnancies complicated by GDM without apparently causing undue stress for the mother and at a potentially lower cost. Therefore, it may be useful in the management of women with GDM. However, its utility in mild GDM not requiring insulin therapy, the optimal management scheme of blood glucose monitoring, and the appropriate threshold of glucose values for initiating insulin therapy have yet to be established. Additional prospective well-controlled studies are needed to address these issues.

Funding Source:

University/Hospital:

Temple University School of Medicine

Reviewer Comments:

Search strategy not described and quality of articles not assessed.

Quality Criteria Checklist: Review Articles
Relevance Questions
	1.	Will the answer if true, have a direct bearing on the health of patients?	Yes
	2.	Is the outcome or topic something that patients/clients/population groups would care about?	Yes
	3.	Is the problem addressed in the review one that is relevant to dietetics practice?	Yes
	4.	Will the information, if true, require a change in practice?	Yes

Validity Questions
	1.	Was the question for the review clearly focused and appropriate?	Yes
	2.	Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described?	No
	3.	Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased?	No
	4.	Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible?	No
	5.	Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined?	Yes
	6.	Was the outcome of interest clearly indicated? Were other potential harms and benefits considered?	Yes
	7.	Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described?	Yes
	8.	Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included?	Yes
	9.	Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed?	Yes
	10.	Was bias due to the review's funding or sponsorship unlikely?	Yes