Læknablaðið : fylgirit - 01.06.1982, Blaðsíða 39

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HOME MONITORING OF BLOOD GLUCOSE IN DIABETIC PREGNANCY.
Gunr.ar Valtysson, Reykjavík and Paul L. Padfield, Edinburgh.
It is now well established that rigid control of blood
glucose in the pregnant diabetic decreases the morbidity and
mortality of the fetus. In this study we have applied home
monitoring of blood glucose during diabetic pregnancy. We have
evaluated the diabetic control and addressed the question
whether more information about blood sugar will provide additi-
onal benefit to the offspring of diabetic mothers.
Twenty-eight insulin dependent pregnant diabetic were
studied at University of Michigan Hospital, Ann Arbor, U.S.A.
Patients were randomly allocated into two groups: Group I
(15 patients) used Eyetone reflectance colorimeter (Ames).
Patients were instructed to obtain daily fasting glucose
values together with one other reading during the day. A
second group, Group II were used as a control and tested the
urine for glucose and ketones four times a day. All patients
attended a high risk clinic at two weekly intervals until 28
weeks qestation and weekly thereafter. All patients received
mixtures of an intermediate and regular insulin twice daily.
A relatively good control was maintained in both groups. Fast-
ing blood glucose was similar throughout the pregnancy in both
groups. During the admission for delivery fasting and afternoon
blood sugars were again similar in both groups. Twenty-nine
babies were born to 28 mothers with no perinatal mortality.
Mild hypoglycemia was common: 6 in Group I and 8 in Group II.
A degree of respiratory distress was seen in 5 in Group I and
4 in Group II. Significant congenital abnormalities occurred
in 2 in each group. The birth weight was similar.
Conclusions: This study revealed no difference between the
groups in diabetic control or perinatal morbidity. However more
patients in Group II required admission to the hospital for
diabetic control. The patients in Group I were more confident
about their control as they had the machines to use if indoubt..
We still believe the machines are quite valuable and their
ability to avoid hospitalization may allow for a more use in
the future.