Poster Session 1
Category: Diabetes
Poster Session 1
Jessica Montgomery, MD (she/her/hers)
Maternal-Fetal Medicine Fellow
Department of Women’s Health, Dell Medical School at the University of Texas at Austin
Austin, Texas, United States
Miriam J. Alvarez, PhD
Research Scientist
Department of Women’s Health, Dell Medical School at the University of Texas at Austin
Austin, Texas, United States
Saniya Gayake, BS
Medical Student
Department of Women’s Health, Dell Medical School at the University of Texas at Austin
Austin, Texas, United States
Kobina Ghartey, MD
Assistant Professor
Department of Women’s Health, Dell Medical School at the University of Texas at Austin
Austin, Texas, United States
Anne Mardy, MD
Assistant Professor
Department of Women’s Health, Dell Medical School at the University of Texas at Austin
Austin, Texas, United States
Lorie M. Harper, MD (she/her/hers)
Associate Professor
Department of Women’s Health, Dell Medical School at the University of Texas at Austin
Austin, Texas, United States
Frequent glucose monitoring for gestational diabetes (GDM) is a source of patient dissatisfaction. Reduced testing frequency may offer a more acceptable yet effective approach to glycemic control in pregnancy. This study aimed to evaluate outcomes with less frequent glucose monitoring compared to standard four-times-daily testing in patients with GDM.
Study Design:
Electronic databases were searched Jan 1990 - Apr 2025 for randomized controlled trials (RCT) or cohort studies comparing four-times-daily to less frequent testing in GDM. Exclusion criteria were other interventions, non-English, unpublished studies, and other study designs. The primary outcome was birth weight. Secondary outcomes were macrosomia, cesarean delivery, neonatal hypoglycemia, and need for medication. Pooled risk ratios (RRs) or mean differences (MDs) were calculated using Mantel-Haenszel random-effects models as appropriate; heterogeneity was assessed with I² and τ².
Results:
Of 1,346 titles and abstracts reviewed, two RCTs and two retrospective cohort studies were included. Study quality was moderate. Less frequent testing was not associated with increased birth weight (MD=131.1g; 95% CI: –8.7-270.9, p=0.07) but was associated with a significantly higher risk of macrosomia (RR=1.4; 95% CI: 1.1-1.7, p=0.01). Cesarean delivery and neonatal hypoglycemia were similar between groups (RR=1.1; 95% CI: 0.9-1.3, p=0.56; and RR=0.96; 95% CI:0.7-1.4, p=0.84). Pharmacologic treatment was more common with less frequent testing (RR=1.4; 95% CI: 1.1-1.7, p=0.01). Heterogeneity was high: RCTs compared daily to every-other-day testing, while cohort studies compared daily to weekly testing. Stratified analysis showed that every-other-day testing resembled daily testing, whereas weekly testing worsened outcomes.
Conclusion:
Reduced glucose testing in GDM is associated with increased risks of macrosomia and pharmacologic treatment. These findings support continued use of standard testing protocols, though further studies should focus on every-other-day testing as a possible strategy to reduce patient burden.