Monitoring blood glucose in gestational diabetes: superiority of preprandial monitoring not proved.(Editorial)

Gestational diabetes mellitus is defined as glucose intolerance first detected during pregnancy with reversion to normal after delivery. It is generally considered a consequence of the endocrine changes of pregnancy in women who are genetically predisposed to non-insulin dependent diabetes. Thus, it is associated with a subsequent cumulative incidence of diabetes as high as 60% after 16 years of follow up.[1] Since blood glucose concentrations do not have a bimodal distribution, the frequency of gestational diabetes will depend on the arbitrary blood glucose concentration chosen for diagnosis.

The impact of gestational diabetes is similar to that of established diabetes, although the complications are fewer and less severe. However, there is little consensus in the literature concerning the biochemical definition, perceived ill effects, or appropriate treatment. For initial treatment, dietary instruction is mandatory, and about a third of women …