1984 Volume 27 Issue 4 Pages 531-539
In an approach for normalizing abnormal metabolism during pregnancy in the treatment of diabetics, we instructed pregnant diabetics how to monitor their own blood glucose, and then assessed this self-monitoring through a comparison of the control of diabetes and outcome of delivery.
The subjects were 21 pregnant diabetics of whom 10 had IDDM and 11 had NIDDM from before pregnancy. The controls consisted of 21 pregnant diabetics who did not monitor their own blood glucose. The subjects and controls were matched for mean age at delivery, diabetes duration before pregnancy, and number of weeks before delivery.
The subjects monitored their own blood glucose an average of 7 times a week. The blood glucose levels, measured at the hospital after self-monitoring started, averaged 98.5mg/dl at fasting and 114.5mg/dl postprandial in IDDM patients which was significantly lower than in controls. There were no significant differences between the blood glucose levels in NIDDM subjects and controls.
The HbAi levels during pregnancy, measured after self-monitoring started, were significantly lower in both IDDM and NIDDM subjects than in controls. The number of macrosomia did not significantly differ in the two groups, i.e. self-monitoring and controls, although there were fewer cases among the self-monitoring subjects.
We found that, in maintaining normoglycemia, insulin-dependent pregnant diabetics whose diabetes control was difficult benefited significantly from monitoring their own glucose, as did noninsulin dependent pregnant diabetics with increasing insulin requirements and who lived far from the hospital. In two representative cases, one woman's retinopathy was ameliorated by self-monitoring even in her second pregnancy, and another woman maintained normoglycemia even when her insulin requirements reached 100 units/day during pregnancy.
