(847) One hour versus two hours postprandial glucose monitoring in gestational diabetes-mellitus: a prospective clinical trial

We aimed to compare perinatal outcomes and patient satisfaction in patients with gestational diabetes mellitus (GDM) monitored by 1-hour versus 2-hours postprandial glucose measurements (PPG1 vs PPG2).

Study Design:

A prospective control trial at a single tertiary center. The study population included patients with GDM, diagnosed by the two-step approach. Patients diagnosed with gestational diabetes who were referred to our ambulatory patient clinics were asked to participate in the trial. Patients were placed in one of two groups Group 1 –PPG1 group 2- PPG2 according to their preference.  All patients otherwise were managed according to our GDM-clinic protocol: patients were placed on appropriate diet by a dietitian and were instructed to self-monitor and document their blood glucose measurements using a glucose meter 4 times a day (fasting + either PPG1 or PPG2 with the appropriate normal and abnormal cutoffs). As per our protocol patients were evaluated every 2 weeks from time of diagnosis to 32 weeks gestation and every one week afterward. Insulin or oral medications were administered as per clinic protocol as well as decisions regarding timing or mode of delivery. Patients were asked to fill in a detailed satisfaction and questionnaire in the last prenatal visit. The study was powered to detect a 25% difference in the primary outcome of composite of adverse neonatal outcomes.

Results:

Overall, 99 patients were recruited 50 in the PPG1 group and 49 in the PPG2 group. Baseline characteristics were comparable between the study groups. The rate of the primary outcome, as well as glycemic control, induction of labor, mode of delivery, and birth weights were comparable between the groups – (Table). All parameters of patient satisfaction were also comparable.

Conclusion: PPG1 and PPG2 postprandial glucose monitoring had comparable outcomes and patient satisfaction. Therefore, we recommend counseling patients to choose either strategy based on personal preference.