Влияние самоконтроля на течение и исходы гестационного сахарного диабета

Abstract

Gestational diabetes mellitus is characterized by an increased risk of fetal macrosomia and obstetric complications during childbirth, as well as the development of type 2 diabetes in the mother after pregnancy. Timely diagnosis and treatment of hyperglycemia during pregnancy reduces adverse pregnancy outcomes. The first step towards tight glucose control during pregnancy is self-monitoring of glycemia. Aim: to evaluate the effectiveness of regular glycemic control using a Satellite express glucometer calibrated on capillary whole blood in patients with gestational diabetes mellitus (GDM) in outpatient practice. Material and methods. The 96-week prospective observational non-interventional study included 150 patients with GDM. In women with confirmed GDM, blood glucose was measured using a satellite express glucometer. At each visit, further tactics for the treatment of GDM were determined based on the results of glycemia (data from the self-monitoring diary). Until the 34th week of pregnancy, an endocrinologist was consulted with a frequency of 1 time in 2 weeks in the form of a medical appointment and telephone contact. After 34 weeks of pregnancy, consultation of an endocrinologist with a frequency of 1 time per week. 6–12 weeks after delivery, an oral glucose tolerance test and consultation with an endocrinologist were performed to assess the degree of carbohydrate metabolism disorder. Results. The participation of 138 (92%) patients in the study ended in childbirth, 12 (8%) patients dropped out of the study ahead of schedule. Spontaneous abortions were noted in patients who performed self-monitoring of glycemia 0–1 times a day, independent births were more often observed in patients who performed self-monitoring 3–4 times a day, and these patients also had more stable glycemic indices. 9 patients out of 138 gave birth to children weighing 4000 g or more. The weight of the rest of the children at birth did not exceed 3500 g. Conclusion. A well-controlled course of GDM, adequate self-monitoring and dynamic observation of women allows delivery to be carried out within the generally accepted terms without worsening its outcomes.