Better Monitoring for Healthier Babies
Women with diabetes who undergo constant monitoring of their blood glucose levels during pregnancy have a better handle on blood glucose control, and have babies with normal birth weights, claims a study published on the British Medical Journal's website (BMJ).
If too much glucose reaches the baby during pregnancy, growth is accelerated and macrosomia, or excessive birth weight in babies, becomes a risk. The larger girth of the baby can lead to a difficult or complicated delivery and may increase the chance of long term insulin resistance, obesity, and type 2 diabetes. While there is evidence to suggest that measuring the maternal blood glucose more often decreases these risks, it has not been known just how frequent such checks need to be in order to gain the optimum benefits.
Dr. Helen Murphy and a group of colleagues looked at continuous glucose monitoring to see if this technique might improve maternal glucose control and reduce the risk of macrosomia in newborns. 71 pregnant women with types 1 or 2 diabetes were culled from prenatal clinics in the UK for this study. The women were assigned either standard, intermittent self-monitoring for glucose levels using the finger prick method, or this method plus a type of continuous glucose monitoring. Continuous glucose monitoring is done through the electronic measuring of glucose in subcutaneous tissues every 10 seconds, and provides a maximum of 288 measurements per day.
There was an attempt in this study to use the continuous method of glucose monitoring as a tool to aid in educating the women in how to make lifestyle changes that would improve the way they manage their blood sugar levels. The women in this group were found to have lower levels of HbA1c, which shows how much glucose is attached to red blood cells, between the 32nd and 36th weeks of gestation. Women in their third trimester on this regimen displayed improved blood glucose control compared to those women in the standard prenatal care group.
The babies of the moms who received the continuous monitoring had babies with lower birth weights. However, the rate of macrosomia was still 3.5 times higher in this group than in the overall maternity population. The authors believe that changes in maternal diet and insulin dosage have done little to affect the higher rates of overweight babies in the diabetic maternal population.
In an article accompanying the published results of this study, Professor Mario Festin states that continuous glucose monitoring is inexpensive when compared to other monitoring systems and feels that as this method gains in popularity it will become even more affordable, even in third world countries.