Self-Monitoring Blood Glucose in gestational diabetes help strictly adhere to their treatment, which improves the safety of both mother & fetal.
Data often suggest patients, who regularly perform SMBG measurements, strictly adhere to their prescribed treatment due to a better understanding of the treatment. And thus, the possibility of active participation in the prescribed therapeutic regimen [American Journal of Medicine 2001, 111(1):1–9.].
BS Monitoring for Gestational Diabetes
What is SMBG? Self-monitoring of blood glucose (SMBG) is the monitoring of blood glucose by you (self). It is an essential component of modern therapy for diabetes (including gestational diabetes) who are on insulin therapy.
Monitoring blood glucose helps to understand how exercise you do and food you eat affect your blood sugars.
During pregnancy, it is necessary to maintain fasting and postprandial blood glucose values as close as possible to those of non-diabetic women. For this, you need to monitor your blood glucose and take necessary steps to correct it.
When should you monitor your blood glucose level?
Many studies show postprandial hyperglycemia beyond the 16th week of pregnancy. It is the main predictor for fetal macrosomia. Ref: The New England Journal of Medicine1995 Nov 9; 333(19):1237-41. & Journal of Perinatal Medicine 2005; 33(2):125-31.
Fasting blood glucose - You need to measure your blood glucose levels every morning when you get up from the bed before you eat or drink anything except water. That is the blood glucose level in an empty stomach after at least 8 hours of fasting.
Pre & Postprandial blood glucose - You need to measure your blood glucose levels before and after every meal. Blood glucose measurement before the meal is pre-prandial. Blood glucose after one or two hours of the meal is post-prandial blood glucose.
Before bed for those on insulin - If you are on insulin therapy, then you may need to take monitor blood glucose before bedtime or even during the night, although this is unusual.
For women with gestational diabetes who are on insulin therapy, some experts even recommend performing SMBG measurements for 6 to 8 times a day. It includes measuring in the morning on fasting, before and 1 or 2 hours after meals, and in the evening before bedtime, sometimes at night [Clinical Chemistry 2011; 57(2): 221-230.].
During pregnancy, peak plasma glucose levels happen between 60 and 90 minutes (1 to 1.5 hours) after eating.
So, it is recommended to monitor one hour after food intake to evaluate potential adjustments in the diet and or the prandial insulin dose.
For women with slow gastric emptying or a high-fat meal might raise the blood glucose with a delay and so it is appropriate to monitor glucose level two hours after meals instead of one.
What are the things you need to monitor blood glucose?
Some of the things you may need to monitor your blood sugar levels are:
- Lancets – a sharp disposable needle-like sticker for prick your finger to obtain a blood drop.
- Lancet devises – a spring-loaded finger sticking device that holds the lancet.
- Test strip – is a chemically treated strip to sense blood sugar in a drop of blood that applied to it.
- Glucose meter – is a device that reads the test strip and gives you a digital number for the blood glucose value.
Blood glucose targets for gestational diabetes
Most gestational diabetes treatment plans involve keeping blood sugar levels as close to normal or target range as possible. This help eliminates the risk associated with gestational diabetes for both mother and the fetus.
Target Blood Glucose Level for Gestational Diabetes | |
Fasting | ≤95 mg/dL (5.3 mmol/L) |
1-hr postprandial | ≤140 mg/dL (7.8 mmol/L) |
2-hr postprandial | ≤120 mg/dL (6.7 mmol/L) |
A1C | 6.0 to 6.5% recommended <6.0% is optimal as the pregnancy progresses Achieve without hypoglycemia |
Ketones Test
Test for ketones in your morning urine. High levels of ketones are a sign that your body is using your body fat for energy instead of the food you eat. Using fat for energy is not recommended and harmful. Ketones may be unhealthy for your baby too.