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The Impact of Self-Monitoring of Blood Olucose on Self-Efficacy and Pregnancy Outcomes in Women With Diet-Controlled Gestational Diabetes

Diabetes-in-Pregnancy Program, Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences; Temple University Hospital, General Clinical Research Center, 4 West, 3401 North Broad Street, Philadelphia, PA 19140 chomko{at}nimbus.ocis.temple.edu

Eyal Sivan, MD

E. Albert Reece, MD, PhD

General Clinical Research Center and the Diabetes-in-Pregnancy Program, Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital, Philadelphia, Pennsylvania.

PURPOSE

The purpose of this study was to examine the effects of self-monitoring of blood glucose (SMBG) on feelings of self-efficacy, dietary compliance, and pregnancy outcomes in women with diet-controlled gestational diabetes mellitus (GDM).

METHODS

Fifty-eight women with GDM and a fasting blood glucose level <95 mg/dL were randomly assigned to 2 groups. The experimental group measured their blood glucose levels 4 times daily using a reflectance meter with memory. Metabolic status was assessed in the control group by periodic monitoring at prenatal visits. Otherwise the management protocol was identical for both groups. The Diabetes Empowerment Scale was completed at study entry and at 37 weeks gestation to assess feelings of self-efficacy. Dietary compliance was assessed at each visit.

RESULTS

Both groups of women achieved excellent glucose control; only 1 woman in each group required insulin therapy. There were no significant differences with regard to feelings of self-efficacy, dietary compliance, birth weight, gestational age at delivery, Apgar scores, and neonatal complications. Rates of macrosomia, delivery by cesarean section, and occurrence of birth trauma were similar.

CONCLUSIONS

SMBG appears to have little effect on maternal feelings of self-efficacy, dietary compliance, or pregnancy outcomes in women with diet-controlled GDM.

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