4 vs 7 points self-monitoring blood glucose in gestational diabetes mellitus on diet modification: randomised clinical trial in a single tertiary centre in Malaysia

Berohan ND 1 , Alias H 2 , Ishak S 2 , Mohammed Nawi A 3 , Azman N 1 , Sohaimi D 1 Show all authors , Kamisan Atan I 1 , Abd Wahab N 4 , Kalok AH 1 , Mohamad AS 1 , Abd Rahman R 5

Affiliations 

  • 1 Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
  • 2 Department of Obstetrics and Gynaecology, Hospital Canselor Tuanku Muhriz, Cheras, 56000, Kuala Lumpur, Malaysia
  • 3 Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Cheras, 56000, Kuala Lumpur, Malaysia
  • 4 Department of Medicine (Endocrine), Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Cheras, 56000, Kuala Lumpur, Malaysia
  • 5 Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia. drrahana@ukm.edu.my
Arch Gynecol Obstet, 2024 Oct;310(4):1959-1965.
PMID: 39110209 DOI: 10.1007/s00404-024-07661-5

Abstract

PURPOSE: There is no standardized best method on monitoring of patients with gestational diabetes on diet modification in the country. This study aims to investigate the optimum method of self-monitoring blood glucose.

METHODS: This is a randomized clinical trial in a single tertiary centre involving patients with gestational diabetes mellitus (GDM) diagnosed based on NICE guideline on diet modification. The patients are randomized in 1:1 ratio to 4 or 7 points self-monitoring blood glucose. The monitoring was required to be done monthly with ultrasound for fetal growth. Blood was taken at recruitment for measurement of serum HbA1c and fructosamine.

RESULTS: A total of 200 patients were recruited. There were significantly more Malay patients in the 7 points group (88.9% vs 78.2%, p = 0.033). Multiparous patients were significantly more in the 4 points group (82.2% vs 68.7%, p = 0.033). Both groups were similar in clinical characteristics. There was no statistical difference in the neonatal outcome particularly fetal macrosomia and admission to neonatal intensive care unit.

CONCLUSIONS: In patients with GDM on diet modification, self-blood glucose monitoring using either 4 or 7 points resulted in similar maternal and perinatal outcomes. The research was registered under ClinicalTrials.gov (NCT04101396) on 17/9/2019 ( https://register.

CLINICALTRIALS: gov/prs/app/action/SelectProtocol?sid=S00098EN&selectaction=Edit&uid=U0004RD4&ts=2&cx=-qlk1w2 ).

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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