COMPARISON OF HOME GLUCOSE MONITORING WITH THE ORAL GLUCOSE-TOLERANCETEST TO DETECT GESTATIONAL GLUCOSE-INTOLERANCE

Background. Recent evidence suggests that infant morbidity is increase d among women who have abnormal prenatal glucose screening tests but w ho do not have gestational diabetes mellitus (GDM). These women fall i nto a diagnostic gray zone and historically have not been treated. Met hods. Forty-eight pregnant women with abnormal oral glucose challenge test results performed self-monitored blood glucose (SMBG) testing sev en times per day for 1 week before undergoing a diagnostic 100-g oral glucose tolerance test (OGTT). At delivery, perinatal complications an d birthweights were recorded. Results of SMBG tests for women with nor mal OGTTs were correlated with infant birthweights. Results. Thirteen infants (37%) were found to be large for gestational age (LGA). Signif icant correlation was found between increasing birthweight and increas ing average fasting SMBG values (P<.001), increasing percentage of SMB G values above 120 mg/dL (6.7 mmol/L) (P<.01), and increasing average SMBG values (P<.016). Conclusions. Maternal home glucose values at 28 weeks correlate with the risk of LGA infant births among women in the diagnostic gray zone. Women with average fasting SMBG values >95 mg/dL (5.3 mmol/L) are at increased risk for giving birth to LGA infants an d may be more likely to exhibit complications usually associated with GDM.