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Daily Glucose Self-Monitoring May Reduce Macrosomia Risk

Daily monitoring more effective than weekly testing in gestational diabetes

MONDAY, May 25 (HealthDay News) -- Daily glucose self-monitoring in women with diet-treated gestational diabetes may be associated with a lower risk of delivering an oversized infant than routine weekly monitoring, according to research published in the June issue of Obstetrics & Gynecology.

J. Seth Hawkins, M.D., of the University of Texas Southwestern Medical Center in Dallas, and colleagues analyzed data from 990 women with diet-treated gestational diabetes who delivered between 1991 and 2001. Women who self-monitored their blood glucose four times daily were compared with those who underwent weekly routine office testing of their blood glucose.

The researchers found that the women in the daily self-monitoring group were less likely to have macrosomic infants -- defined as 4,000 grams or more -- than the women in the weekly office-monitoring group (21.9 versus 29.5 percent). They were also less likely to have large-for-gestational-age infants (23.1 versus 34.4 percent). The authors further note that the daily self-monitoring group gained significantly less weight. However, they had higher average fasting glucose levels, and improvement of these values was similar between the groups.

"Although glycemic control plays an important role in determining fetal size, excessive maternal weight gain and obesity also strongly influence neonatal birth weight, even in women without glucose intolerance. The majority of women in our study were obese at presentation for prenatal care, but those monitored daily gained significantly less weight per week than those monitored weekly during their clinic visits," the authors write.

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