Treating Mild Gestational Diabetes Reduces Risks Of Complication, Improves Health

Main Category: Pregnancy / Obstetrics
Also Included In: Diabetes;  Pediatrics / Children's Health
Article Date: 05 Oct 2009 - 2:00 PST

email to a friend   printer friendly   view / write opinions

Treating even mild forms of gestational diabetes can reduce the likelihood of complications for the woman and her infant, according to a recent study in the New England Journal of Medicine, the Los Angeles Times reports. More women are experiencing gestational diabetes, as more women are overweight when they become pregnant, the Times reports. Doctors have not been sure whether they should treat milder forms of the condition; moderate to severe cases of gestational diabetes are always treated (Roan, Los Angeles Times, 10/1). As defined by current guidelines, gestational diabetes occurs in up to 14% of all pregnancies, usually depending on a woman's weight and age, and about one-third of the cases are considered mild.

The study was financed by the Eunice Kennedy Shriver National Institute for Child Health and Human Development and conducted at medical centers throughout the U.S. (Rubin, USA Today, 9/30). It monitored 958 women with mild gestational diabetes who were between 24 and 31 weeks pregnant. Those who received treatment -- including diet counseling, glucose monitoring and, if necessary, insulin -- gained less weight and had a reduced risk of preterm births and preeclampsia.

Most of the infants in the study were born at normal weights. Only 7.1% of infants born to women in the treated group had birthweights at or above the 90th percentile, considered "too large," compared with 14.5% of infants born to untreated women. Infants of treated women also were less likely to be born via caesarean section or experience trauma at birth (Los Angeles Times, 10/1).

The study's lead author, Mark Landon, professor of obstetrics and gynecology at the Ohio State University Medical Center, said, "While many obstetricians screen for and attempt to treat gestational diabetes, they may not pay as close attention to treating women with milder forms" (USA Today, 9/30). According to Landon, "There is every reason to fully treat women with even the mildest (gestational diabetes) based on our results," noting that only 7% of the women in the treated group required insulin, while 93% kept their glucose levels in control with diet alone (Nano, AP/Boston Globe, 10/1).

In an accompanying editorial, David Sacks, an ob-gyn at the Kaiser Foundation Hospital in Bellflower, Calif., writes that this trial and a similar one conducted in 2005 "clearly support the treatment of gestational diabetes" but that the question of whom to treat remains. Boyd Metzger, professor of metabolism and nutrition at the Northwestern University Feinberg School of Medicine, said that yet-to-be-published international guidelines for diagnosing gestational diabetes will expand the number of women defined as having the condition (USA Today, 9/30).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.