Based on a study of more than 23,000 women in nine countries, Metzger and an international group of 50 experts concluded a fasting blood sugar level of 92 or higher, a one-hour level of 180 or higher on a glucose tolerance test or a two-hour level of 153 or higher on a glucose tolerance test constitute serious risks to the mother and baby. Previously, these levels had been considered in the safe, normal range, and two elevated levels were required for a diagnosis of gestational diabetes.
"At these levels, the frequency of having an overweight baby is almost double, the frequency of having preeclampsia is almost double, and the frequency of early delivery is 40 percent greater," Metzger said. "These are really substantial differences."
The group of international experts in gestational diabetes spent almost two years determining how to apply findings from a 2008 study, also led by Metzger, that found a much lower level of a pregnant woman's blood sugar than previously believed increased the risk of serious complications.
The researchers set their new diagnosis and treatment criteria by determining the blood sugar level that nearly doubled the risks to the baby and mother.
"This study says these risks to pregnancy are like many things we deal with in medicine," Metzger said. "The risk of having a stroke doesn't begin when your blood pressure is 140 over 80. That's when we say you have hypertension, but that's not where the risk begins to affect your health. That starts sooner. A similar situation is how your cholesterol level relates to the risk of having heart disease. It doesn't begin at 200. That's where it reaches the threshold where common treatments can reduce the risks."
"Our research represents an examination of risks and a consensus about how high a level the risk needs to reach before a diagnosis should be made and
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| Contact: Marla Paul marla-paul@northwestern.edu 312-503-8928 Northwestern University Source:Eurekalert |