Self-monitoring of blood glucose in gestational diabetes mellitus

About 6% of all pregnancies are complicated by gestational diabetes mellitus in France. Consensus is obtained for defining but not for the screening and diagnosis criteria. Management of gestational diabetes mellitus reduce materno-foetal morbidity. Postprandial blood glucose peaks are highly predictive of macrosomia and have to be controled in strict rates : less than 1.40 g/liter one hour after meal and less than 1.20 g/liter two hours after meal. Self-monitoring of blood glucose allows to start more rapidly insulintherapy, to obtain a better glycemic control and to reduce macrosomia. The impact of self-monitoring appears to be lower in the management of diet-controlled gestational diabetes. After delivery, self-monitoring of blood glucose can be used to control normalisation of blood glucose of women with high risk of type 2 diabetes mellitus.