Evaluating the effectiveness of single time fasting and postprandial glucose testing on post-partum day 3 vs capillary blood glucose monitoring in post-partum woman with GDM on MNT -A Prospective Comparative study
Keywords:
Gestational diabetes, postpartum monitoring, fasting blood glucose, cost-effectiveness, patient satisfactionAbstract
Background: Postpartum glucose monitoring is critical for women with gestational diabetes mellitus (GDM) to identify persistent dysglycemia, yet adherence to traditional capillary blood glucose (CBG) monitoring remains challenging. This study evaluated whether fasting (FBS) and postprandial (PPBS) blood glucose measurements on postnatal day 3 could provide a simpler, equally effective alternative to three-day CBG monitoring in GDM patients managed with medical nutrition therapy (MNT).
Methods: In this prospective comparative study conducted at Saveetha Medical College and Hospital, 120 postpartum women with GDM were randomized to either FBS/PPBS testing on day 3 (n=60) or standard three-day CBG monitoring (n=60). Glycemic control, patient satisfaction, neonatal outcomes, and cost-effectiveness were assessed. Statistical analyses included t-tests, chi-square tests, and correlation analyses.
Results: No significant differences were found in hyperglycemia detection rates (13.3% vs. 16.7%, p=0.61) or neonatal outcomes (hypoglycemia: 8.3% vs. 10.0%, p=0.75) between FBS/PPBS and CBG groups. FBS/PPBS strongly correlated with CBG values (fasting: r=0.89; postprandial: r=0.85, p<0.001). Patient satisfaction was significantly higher with FBS/PPBS (pain score: 2.1 vs. 5.8; convenience score: 8.5 vs. 4.3, p<0.001), with 90% preferring this method. The FBS/PPBS approach was threefold cheaper (15vs.15vs.45) and required less time (20 vs. 120 minutes).
Conclusion: Single-day FBS/PPBS monitoring is as effective as three-day CBG testing for postpartum glucose assessment in GDM patients on MNT, with superior patient acceptability and cost-efficiency. These findings support revising current guidelines to incorporate simplified monitoring strategies, particularly for low-risk women, without compromising clinical outcomes. Future studies should validate these results in diverse populations and assess long-term diabetes prevention benefits.
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