RT Journal Article
SR Electronic
T1 PM.76 A Question of Probity: Phantom Blood Glucose Value Recording in a Self-Monitoring Pregnant Diabetic Woman
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP A46
OP A46
DO 10.1136/archdischild-2013-303966.157
VO 98
IS Suppl 1
A1 A Adeyemo
A1 M Hicks
A1 A Kulkarni
A1 Z Ramsey-Marcelle
YR 2013
UL http://fn.bmj.com/content/98/Suppl_1/A46.3.abstract
AB Introduction A successful doctor-patient relationship is based on perceived mutual trust. The importance of this is underscored in pregnant diabetic women where self monitoring of blood glucose (SMBG) levels by patients’ informs and directs shared clinical decisions which impact significantly on their lifestyle, diet and medication adjustments so that a good pregnancy outcome is achieved. Case Report A 29 yr old para2 woman with type 2 diabetes was booked and followed up in the combined antenatal diabetic clinic through her third pregnancy. She required metformin and subcutaneous insulin injections to control her blood glucose prior to conception. These were continued in pregnancy with an increase in the frequency of blood glucose monitoring. At 28 weeks of pregnancy, it was noted that blood glucose values recorded in her logbook over the course of 8 weeks consistently showed fasting levels <5 mmol/l and 1 hr postprandial levels <7 mmol/l despite HbA1C levels of 72 mmols/mol (8.7%) and ultrasound scan showing fetal macrosomia and significant polyhydramnios. A review of her glucometer identified difference in the values stored in the memory and that recorded in her logbook. This discrepancy was brought to her notice and she divulged falsifying the values. She was delivered by emergency caesarean section for fetal compromise at 32 weeks gestation. Conclusion Accuracy of home metres and diary logs needs to be confirmed at regular intervals, and SMBG values should not be the only criterion for diabetes management during pregnancy.