85 - Daily Versus Every-Other Day Glucose Monitoring in Gestational Diabetes Mellitus: A Randomized Controlled Trial

Saturday, February 11, 2023

8:15 AM – 8:30 AM

Location: Room 3018, Moscone West, Level 3

Objective: The objective of this study was to assess if universal use of every other day glucose monitoring in women with gestational diabetes mellitus (GDM) resulted in similar birth weights and pregnancy outcomes, and preferred to every day glucose monitoring.

Study Design: IRB approved noninferiority randomized controlled trial. Eligible pregnant women who received care between April 2021 and May 2022 with a singleton pregnancy diagnosed with GDM after 20 weeks were enrolled. Women were randomly assigned to test blood glucose values daily (D) or every other day (EOD). Noninferiority would be declared if the mean birth weight in the every-other-day group was no higher than 200g. Satisfaction was assessed using the validated Oxford Maternity Diabetes Treatment Satisfaction Questionnaire.

Results:

A total of 197 women were enrolled. Baseline characteristics were similar. There was no difference in the number of patients requiring medication, the gestational age medication was started, or the type of medication required between groups. Average fasting and post prandial glucose values were similar between groups. The primary outcome of birth weights was similar in both groups: 3090+/-418 g among newborns in the D group and 3181+/-482 g among newborns in the EOD group. The EOD group was found to be non-inferior to the ED group (p=0.046) with an upper confidence limit for the mean difference in mean birth weight of 197g, which was below the non-inferiority margin of 200g. Gestational age at delivery as well as mode of delivery did not differ between both groups. There was no difference between groups in perinatal or neonatal morbidities. There was no difference in patient satisfaction between groups.

Conclusion: Our results suggest that in patients with GDM, testing blood glucose values every other day was as effective as testing every day in the management of GDM, without apparent effects on birth weight, medication initiation, glucose control, or timing of delivery. This simple intervention might help decrease the emotional, physical and financial burden many pregnant woman face with the diagnosis of GDM.

Primary & Presenting Author(s)

Kristina M. Feldman, DO

Dr.
Icahn School of Medicine at Mount Sinai West
New York, NY, United States

Slides

Coauthor(s)

AC

Arielle Coughlin, MD

Icahn School of Medicine
New York, NY, United States
JF

Jasmine Feliciano, MD

Icahn School of Medicine
New York, NY, United States
GS

Guillaume Stoffels, PhD

Statistician
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Tirtza Spiegel Strauss, MD

Fellow
Mount Sinai West, Icahn School of Medicine at Mount Sinai
New York, New York, United States
OG

Olivia Grubman, MD, MPH

Icahn School of Medicine at Mount Sinai
New York, New York, United States
ZA

Zainab Al-Ibraheemi, MD

Icahn School of Medicine at Mount Sinai
New York, New York, United States
DC

David Cole, MD

Mt. Sinai West
New York, New York, United States
GA

Graham Ashmead, MD

Roosevelt Hospital
New York, New York, United States
Farrah N. Hussain, MD

Assistant Professor
Icahn School of Medicine at Mount Sinai
New York, New York, United States
SS

Sophia Scarpelli-Shchur, RN, CDE, RN

Icahn School of Medicine at Mount Sinai
New York, New York, United States
LB

Lois Brustman, MD

St. Luke's Roosevelt Hospital Center
New York, New York, United States