Is self-monitoring of blood glucose necessary in the management of gestational diabetes mellitus?

There continues to be controversy regarding the role of blood glucose in the management of pregnant women with gestational diabetes mellitus (GDM), specifically with regard to the use of capillary versus venous samples, as well as the frequency and timing of blood glucose determinations. At the Third International Workshop Conference it was noted that "self-monitoring of capillary blood glucose has been useful in allowing the woman to participate in her own management," but its utility "in the mild GDM not requiring insulin, although reasonable and logical, has not been formally proved." This article reviews the existing evidence in the literature regarding the impact of self-monitoring of blood glucose on outcomes in pregnancies complicated by gestational diabetes. Data regarding the optimal timing, accuracy, costs, and psychosocial effects of self-monitored glucose determinations will also be explored.