Management of the pregnant diabetic: home or hospital, with or without glucose meters?

Abstract

Thirteen pregnant insulin-dependent diabetic patients were allocated to blood-glucose self-monitoring (meter) or conventionally treated (non-meter) groups at 30--31 weeks. A day-profile of blood-glucose and intermediary metabolite levels was obtained 2 weeks later at home and after routine admission to hospital at 35--36 weeks. Metabolic profiles were also obtained in eight normal pregnant women of equivalent gestational ages admitted to hospital for study. The mean blood-glucose and metabolite concentrations in both the meter and non-meter groups were similar to those obtained in the non-diabetic pregnant women (mean diurnal blood-glucose 4.6 +/- 1.1 mmol/l, meter group; 5.3 +/- 1.5 non-meter group; 4.8 +/- 0.8 controls). The diabetic control achieved at home was not improved by the use of a meter or admission to hospital (mean glucose at home 5.0 +/- 1.3 and 6.3 +/- 1.6 mmol/l in hospital). Both the use of a meter and admission to hospital may be valuable in some patients. Neither, however, is essential for the good control of blood-glucose in all pregnant diabetics.