Two Days per Week Versus Daily Blood Glucose Monitoring in Diet-Controlled Gestational Diabetes Mellitus — ASN Events
  1. Schedule
  2. Lunch & Poster Session
  3. Two Days per Week Versus Daily Blood Glucose Monitoring in Diet-Controlled Gestational Diabetes Mellitus

Two Days per Week Versus Daily Blood Glucose Monitoring in Diet-Controlled Gestational Diabetes Mellitus (#107)

Michael Do 1 , Rachel Hicks 1 , Elizabeth Fletcher 2 , David Simmons 1 2
  1. Western Sydney University, Campbelltown
  2. Campbelltown Hospital, Campbelltown, NSW, Australia

Background:  

Standard gestational diabetes mellitus (GDM) care requires self-monitoring of blood glucose (BG) four times daily, 7 days/week. Frequent BG testing is uncomfortable and costly. Evidence supporting whether lower-intensity BG monitoring provides comparable glycaemic information is limited. 

Objective:  

To compare glycaemic information between reduced-frequency BG monitoring (4 days over 2 weeks) and standard frequency (14 days over 2 weeks) in women with diet-managed GDM. 

Methods:  

Retrospective analysis of paired 14-day and 4-day BG datasets from women with diet-managed GDM enrolled in a digital monitoring system (NetHealth). Two monitoring days per week were selected using an electronic randomiser. Corresponding mean fasting and post-prandial BG over 14 and 4 days were compared using paired samples t-tests.  Local escalation criteria were defined as ≥2 fasting blood glucose readings ≥5.3 mmol/L and/or ≥4 post-meal readings ≥7.0 mmol/L, and were applied to both monitoring strategies over the same 2-week period. 

Results:  

4786 BG readings were obtained from 86 women with diet-managed GDM testing 4 times per day over 14 days. 

Mean fasting glucose was 5.2±0.6 mmol/L with 14-day monitoring compared with 5.2±0.6 mmol/L with 4-day monitoring (p=0.71). Mean post-breakfast glucose was 5.6±0.7 mmol/L versus 5.6±0.9 mmol/L, respectively (p=0.31). Mean post-lunch glucose was 6.1±0.8 mmol/L versus 6.1±0.9 mmol/L (p=0.56). Mean post-dinner glucose was 6.2±0.7 mmol/L with 14-day monitoring and 6.2±0.8 mmol/L with 4-day monitoring (p=0.70). 

73 (84.9%) of women met local escalation criteria using 14-day daily monitoring compared with 50 (58.1%) using 4-day reduced-frequency monitoring. Using fortnight-based escalation criteria (≥2 fasting or ≥4 post-prandial readings above target), reduced-frequency monitoring demonstrated a sensitivity of 68.5% and specificity of 100% compared with daily monitoring. 

Conclusion:  

Reduced-frequency BG monitoring (two days per week) produced similar fasting and post-prandial glucose distributions to daily monitoring. Fewer women met escalation criteria under reduced-frequency monitoring, reflecting the dependence of count-based thresholds on the number of observations rather than a true difference in glycaemic control.