Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Université Paris 13, CRNH-IdF, CINFO, Bondy, France
UMR U1153 INSERM/U11125 INRA/CNAM, Unité de Recherche Epidémiologique Nutritionnelle, Université Paris 13, Bobigny, France.
Diabetes Care. 2017 Sep;40(9):1181-1186. doi: 10.2337/dc17-0369. Epub 2017 Jul 19.
To evaluate the compliance with self-monitoring of blood glucose (SMBG) and the reliability of diabetes logbooks in women with gestational diabetes mellitus (GDM), as well as the associated determinants and outcomes.
We prospectively selected French-speaking women with newly diagnosed GDM who had been referred to our diabetes management program and understood SMBG principles. At the next follow-up visit, we collected SMBG results from glucose meters and logbooks. We analyzed pregnancy outcomes.
Data were analyzed over 13 ± 3 days in 91 women. Only 61.5% had performed ≥80% of the required tests. Poor compliance was associated with a family history of diabetes, social deprivation, and non-European origin. The average time between pre- and postprandial tests was 141 ± 20 min, with 46.5% of women performing ≥80% of postprandial measurements 100-140 min after meals. Inadequate timing was associated with ethnicity and higher HbA at baseline. A total of 23.1% of women had <90% matched values in diary and meter memory, and a poor concordance was associated with a family history of diabetes. Poor adherence was associated with more preeclampsia (12.2 vs. 1.9%, = 0.049), and inadequate postprandial test timing with a higher HbA at delivery (5.3 ± 0.4 vs. 5.0 ± 0.3% [34 ± 2 vs. 31 ± 2 mmol/mol], < 0.01), despite more frequent insulin therapy.
Although women with GDM are considered to be highly motivated, SMBG adherence and reliability are of concern and may be associated with poor gestational prognosis, suggesting that caregivers should systematically check the glucose meter memory to improve GDM management.
评估妊娠期糖尿病（GDM）女性的自我血糖监测（SMBG）依从性和糖尿病日志的可靠性，以及相关的决定因素和结局。
我们前瞻性地选择了新诊断为 GDM 的法语女性，并将其转诊到我们的糖尿病管理计划中，这些女性理解 SMBG 原则。在下一次随访时，我们从血糖仪和日志中收集 SMBG 结果。我们分析了妊娠结局。
在 91 名女性中，数据在 13±3 天内进行了分析。只有 61.5%的女性完成了≥80%的要求测试。依从性差与糖尿病家族史、社会贫困和非欧洲血统有关。餐前和餐后测试之间的平均时间为 141±20 分钟，46.5%的女性在餐后 100-140 分钟内进行了≥80%的餐后测量。不适当的时间与种族和基线时更高的 HbA 有关。共有 23.1%的女性在日记和血糖仪记忆中匹配值<90%，较差的一致性与糖尿病家族史有关。依从性差与子痫前期发生率更高（12.2% vs. 1.9%， = 0.049）有关，而餐后测试时间不适当与分娩时 HbA 更高（5.3±0.4 vs. 5.0±0.3%[34±2 vs. 31±2 mmol/mol]， <0.01）有关，尽管胰岛素治疗更频繁。
尽管 GDM 女性被认为是高度积极的，但 SMBG 的依从性和可靠性令人担忧，可能与不良的妊娠预后有关，这表明护理人员应系统地检查血糖仪记忆，以改善 GDM 管理。
