Navigation Links
Study Urges Treatment for Even Mild Gestational Diabetes
Date:9/30/2009

Women, babies alike benefit when therapy goes to more than just severe cases, experts say

WEDNESDAY, Sept. 30 (HealthDay News) -- Pregnant women who receive treatment for the mildest forms of gestational diabetes -- including diet and exercise intervention, self-monitoring of blood glucose levels and possibly insulin therapy -- are less likely to have serious birth complications or develop preeclampsia or high blood pressure during pregnancy, according to new research.

It's been unclear whether treating borderline cases of gestational diabetes would make a difference in pregnancy outcomes. But the study's lead author, Dr. Mark Landon, professor and interim chair of obstetrics and gynecology at Ohio State University Medical Center, said that the finding "demonstrates that there's a significant clinical benefit to treating even the mildest form of gestational diabetes."

Results of the study are published in the Oct. 1 issue of the New England Journal of Medicine.

"Now, we have two randomized, controlled trials, and both showed decreases in big babies, preeclampsia and maternal weight gain," said Dr. David Sacks, a maternal-fetal medicine specialist at Kaiser Foundation Hospital in Bellflower, Calif., and the author of an accompanying editorial in the same issue of the journal. The second study he referred to was done in Australia and published in 2005.

Gestational diabetes is a transient form of diabetes that occurs during pregnancy. However, women who've had gestational diabetes have been shown to have a higher risk for developing type 2 diabetes later in life. Depending on the criteria used to define gestational diabetes, the condition occurs in between 1 percent and 14 percent of all pregnancies, according to Landon's study.

"The frequency of gestational diabetes is increasing worldwide, and while most obstetricians screen for this condition, some have remained skeptical about treating mild gestational diabetes, and are not as aggressive in treating milder forms with dietary intervention and self-blood glucose monitoring," Landon explained.

To get a better idea of whether treating women with mild forms of gestational diabetes could make a difference, he and his colleagues recruited 958 pregnant women who were classified as having mild gestational diabetes.

A treatment group of 485 of the women were given counseling on diet and exercise, taught how to monitor their own blood sugar levels and given insulin when necessary. The other 473, considered the control group, received standard pregnancy care. Only 7 percent of the women in the treatment group required insulin, Landon said.

The study found that the frequency of babies born too-large for their gestational age was reduced by more than half -- 14.5 percent of the control group versus 7.1 percent of the treatment group had big babies. The pregnancy complication known as shoulder dystocia, which means that the shoulders have gotten so large they're difficult to deliver, was found to be 4 percent in the control group and 1.5 percent in treated group.

Cesarean delivery rates also were lower for women who received treatment for their gestational diabetes -- 26.9 percent compared with 33.8 percent of the control group. Women who received treatment also had lower rates of preeclampsia and high blood pressure -- 8.6 percent versus 13.6 percent in the control group, the study found.

Landon said that the reduction of many of the birth complications resulted from the mother's blood sugar being under control, which doesn't cause overnourishment of the baby and thus the baby's size stays closer to normal.

Neither Landon nor Sacks could explain the reduction in preeclampsia and high blood pressure. Sacks theorized that because both diabetes and high blood pressure are inflammatory processes, what helps reduce one might also help the other. But, he added, no one really knows right now.

What is clear, said Dr. Miriam Greene, an obstetrician and gynecologist at NYU Langone Medical Center, is that "when women with mild gestational diabetes are treated well, there's a decreased incidence of birth trauma." Greene said that she's already been treating women with the mildest forms of gestational diabetes, and that it does make a difference.

Sue McLaughlin, president of health care and education for the American Diabetes Association, said that the study provides "another example of how preventive health care pays off in positive health outcomes and may save lives, dollars in the health-care system and improve the quality of life in future years for these families."

According to McLaughlin, "Physicians need to take a proactive role in educating women of childbearing age about their risk for this condition so that women can implement healthy lifestyle behaviors, which promote weight control and prevention of excessive weight gain in this and future pregnancies."

More information

The American Diabetes Association has more on gestational diabetes.



SOURCES: Mark B. Landon, M.D., professor and interim chairman, obstetrics and gynecology, Ohio State University Medical Center, Columbus, Ohio; David A. Sacks, M.D., maternal-fetal medicine specialist, Kaiser Foundation Hospital, Bellflower, Calif.; Miriam Greene, M.D., obstetrician/gynecologist, NYU Langone Medical Center, New York City, and clinical assistant professor, NYU School of Medicine, New York City; Sue McLaughlin, R.D., president, health care and education, American Diabetes Association, Alexandria, Va.; Oct. 1, 2009, New England Journal of Medicine


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Penn study finds pro-death proteins required to regulate healthy immune function
2. New study shows promise in reducing surgical risks associated with surgical bleeding
3. Study, meta-analysis examine factors associated with death from heatstroke
4. Study suggests loss of 2 types of neurons -- not just 1 -- triggers Parkinsons symptoms
5. Study says COPD testing is not measuring up
6. Preclinical study suggests organ-transplant drug may aid in lupus fight
7. Ability to cope with stress can increase good cholesterol in older white men, study finds
8. High alcohol consumption increases stroke risk, Tulane study says
9. Mailman School of Public Health study examines link between racial discrimination and substance use
10. Pitt study finds inequality in tobacco advertising
11. Stanford study highlights cost-effective method of lowering heart disease risks
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... June 24, 2016 , ... A recent article published June 14 ... The article goes on to state that individuals are now more comfortable seeking to ... operations such as calf and cheek reduction. The Los Angeles area medical group, Beverly ...
(Date:6/24/2016)... ... ... Marcy was in a crisis. Her son James, eight, was out of control. Prone to ... , “When something upset him, he couldn’t control his emotions,” remembers Marcy. “If there ... my other children and say he was going to kill them. If we were ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience with all ... brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary ...
(Date:6/24/2016)... ... ... People across the U.S. are sharpening their pencils and honing their writing ... which patients and their families pay tribute to a genetic counselor by nominating him ... Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. , In April, Genome ...
(Date:6/24/2016)... ... June 24, 2016 , ... Puradigm® & Innovative Solutions today ... cultivation and processing operations at its production facility, and opened its first two ... the manufacturer of a complete system of proactive air and surface purification solutions ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Calif. , June 23, 2016 Any dentist ... many challenges of the current process. Many of them do ... of the technical difficulties and high laboratory costs involved. And ... to offer it at such a high cost that the ... it. Dr. Parsa Zadeh , founder of ...
(Date:6/23/2016)... -- Research and Markets has announced the addition ... - Forecast to 2022" report to their offering. ... to date financial data derived from varied research sources to ... potential impact on the market during the next five years, ... of sub markets, regional and country level analysis. The report ...
(Date:6/23/2016)... June 23, 2016 , , ... July 7, 2016 , , , , LOCATION: , , ... , , , EXPERT PANELISTS:  , , , Frost & ... Analyst, Christi Bird; Senior Industry Analyst, Divyaa Ravishankar and Unmesh Lal, ... The global pharmaceutical industry is witnessing an exceptional era. Several new ...
Breaking Medicine Technology: