10 readings a day required to maintain good readings. A group of researchers led by Dr Anneloes Kerssen of the University Medical Centre Utrecht in the Netherlands, determined the optimal target HbA1c levels and the use of self-monitoring of blood glucose (SMBG) in pregnant women with type 1 diabetes. A total of 43 women were asked to use a continuous glucose monitoring system (CGMS) once in each trimester in addition to SMBG. Results were compared among women with HbA1c levels of 4.0-6.0%, 6.0-7.0%, and >7.0%. Correlations between SMBG and CGMS measurements were made among women with 4-5, 6-9, or 10 or more SMBG measurements daily.
The researchers found that glucose concentrations obtained by CGMS were significantly better in patients with a HbA1c level of 6.0% or lower, compared with those with HbA1c>6.0%. No difference in glucose concentrations by CGMS were found between women with HbA1c 6.0-7.0% or >7.0%. Hyper- and hypoglycemic episodes were more readily detected in patients with 10 or more SMBG measurements daily, compared with those with fewer daily measurements.
The researchers concluded that, for pregnant women with type 1 diabetes, optimal glycemic control required a target HbA1c level of 6.0% or lower, and that at least 10 SMBG measurements daily were necessary to accurately reflect daily fluctuations in glucose concentrations.
Diabetologia [published online 9 December 2005
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