Response to Comment on: Hernandez et al. Patterns of Glycemia in Normal Pregnancy: Should the Current Therapeutic Targets Be Challenged? Diabetes Care 2011;34:1660–1668

Abstract

We appreciate Ryan's (1) thoughtful comments. The intent of our pooled analysis was to describe a normal pattern of glycemia in nonobese pregnant women according to the published data (2). We demonstrated that, similar to the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study (3), glucose concentrations in normal pregnancy are lower than were previously appreciated. If the treatment goal for pregnancies affected by diabetes is to mimic patterns of glycemia in normal pregnancy, then a contemporary understanding of normo- or euglycemia is warranted. On the basis of our review, we suggested that prospective trials test whether 1- and 2-h postprandial (PP) targets of <122 and <110 mg/dL can attenuate incidence of fetal macrosomia and large-for-gestational-age (LGA) …