From the Guidelines
For a patient with newly diagnosed gestational diabetes attempting diet control, the standard daily regimen includes checking blood glucose four times daily: once fasting (upon waking, before breakfast) and three times after meals (1-2 hours after starting each meal), with target glucose values of fasting less than 5.3 mmol/L, and 1-hour postprandial less than 7.8 mmol/L or 2-hour postprandial less than 6.7 mmol/L, as recommended by the American Diabetes Association 1.
Importance of Timing and Recording
The timing of these checks is crucial, with the fasting check occurring after at least 8 hours without eating, and postprandial checks precisely timed from the start of meals. Patients should record these values in a logbook or app to track patterns and bring to prenatal appointments. This consistent approach helps identify glucose patterns that can guide dietary adjustments.
Rationale Behind Targets
These targets aim to mimic normal pregnancy glucose levels, as elevated blood glucose can cross the placenta and cause excessive fetal growth, potentially leading to delivery complications and neonatal hypoglycemia. The American Diabetes Association recommends achieving these targets to minimize risks associated with gestational diabetes 1.
Adjustments and Monitoring
If these targets cannot be consistently achieved with diet control within 1-2 weeks, medication therapy may be necessary. Regular monitoring and adjustments to the diet or treatment plan are essential to maintain optimal glucose control and prevent complications. The goal is to keep blood glucose levels as close to normal as possible to ensure the best outcomes for both mother and baby, as supported by recent guidelines 1.
From the Research
Standard Daily Regimen for Glucose Checks
- The standard daily regimen for glucose checks in patients with newly diagnosed gestational diabetes trying diet control is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, study 4 mentions the use of a 72-hour continuous glucose monitoring (CGM) system as a supplementary tool for glucose monitoring in patients with gestational diabetes mellitus (GDM).
Target Glucose Number
- The target glucose number for patients with newly diagnosed gestational diabetes trying diet control is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- Study 5 mentions that diet and exercise therapy can be a successful intervention for women with GDM, but does not provide specific target glucose numbers.
- Study 6 discusses changes in diet and exercise in pregnant women after diagnosis with GDM, but also does not provide specific target glucose numbers.
Glucose Monitoring and Control
- Study 4 found that the use of CGM combined with routine antenatal care can improve glycemic control and pregnancy outcomes in patients with GDM 4.
- Study 5 found that women with diet-treated GDM and a body mass index (BMI) < 25 kg/m(2) had similar outcomes to those with normal glucose tolerance (NGT) 5.
- Study 6 found that women with GDM made modest dietary improvements and maintained their pre-diagnosis exercise routine after diagnosis, but opportunities remain to further improve dietary intake and exercise 6.