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Same results with half the finger pricks?

Study finds current standard of blood glucose monitoring for pregnant women with gestational diabetes may be excessive

Toronto, October 29, 2019

By Jennifer Stranges

Dr. Joel Ray
Dr. Joel Ray

New research from St. Michael’s Hospital of Unity Health Toronto suggests some pregnant women with controlled gestational diabetes mellitus could check their blood glucose just twice a day instead of the current standard of four times a day and still get nearly equivalent results.

In addition to the added convenience and reduced discomfort from needing to perform just half as many finger pokes, a new standard could provide significant cost savings.

“Blood test strips are expensive,” said lead author of the study Dr. Joel Ray, a physician and scientist at the Li Ka Shing Knowledge Institute of St. Michael’s, who noted they can add up to between $120 and $330 per pregnancy.

“Our pilot study sets the stage for establishing the cost benefits of just checking blood glucose twice daily in women with gestational diabetes mellitus, especially among those whose blood sugar is stable in pregnancy.”

In the study published in the Canadian Journal of Diabetes, researchers found that twice-daily blood glucose testing generated 14-day average values nearly equivalent to four times daily testing.

The study evaluated over 30 women with gestational diabetes who attended the Diabetes in Pregnancy Clinic at St. Michael’s over a one-year period. Participants logged their blood glucose levels each day and returned the log after they gave birth. Researchers randomly selected two of the four blood glucose measurements on each given day and compared them to the values of all four.

For women with gestational diabetes with unstable glucose control or who require diabetes medication, the standard of testing four times daily should continue, Dr. Ray said.

There is more to be learned about the obstetrical outcomes in women who monitor their blood glucose levels twice daily versus four times daily, Dr. Ray added, and his team intends to explore that next.

Between three to 20 per cent of pregnant women develop gestational diabetes, and while it can be managed through diet and lifestyle modifications, it is associated with higher rates of bigger babies, cesarean delivery, and is also a hallmark of premature development of type 2 diabetes.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit

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