Treatment of Gestational Diabetes Mellitus

Abstract

Crowther CA, Hiller FE, Moss JR, McPhee AJ, Jeffries WS, Robinson JR, for the Australian Carbohydrate Intolerance Study in Pregnant Women Trial Group: Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med352 : 2477-2486,2005 [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Objective. To determine whether treatment of women with mild gestational diabetes mellitus (GDM), i.e., GDM that would meet the criteria for impaired glucose tolerance (IGT) in the nonpregnant state, decreases the risk of perinatal complications and to assess the effects of treatment on maternal outcome, mood, and quality of life. Design. At the time this trial was initiated, the World Health Organization (WHO) recommended that the management of IGT during pregnancy should be the same as for diabetes,1 a recommendation that differed from that of the National Diabetes Data Group.2 The trial reported by Crowther et al. and reviewed here enrolled only women who fit into this controversial category. Researchers at multiple centers in Australia and the United Kingdom randomly assigned 1,000 women who were diagnosed with GDM at 24-34 weeks of gestation to either an intervention group or a routine-care group. They admitted to the study only women with one or more risk factors for diabetes or a positive 50-g oral glucose challenge test in addition to a fasting glucose of < 140 mg/dl and a 75-g oral glucose tolerance test 2-hour glucose concentration of 140-199 mg/dl. The intervention group received individualized dietary advice, … [1]: {openurl}?query=rft.jtitle%253DN%2BEngl%2BJ%2BMed%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJMoa042973%26rft_id%253Dinfo%253Apmid%252F15951574%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1056/NEJMoa042973&link_type=DOI [3]: /lookup/external-ref?access_num=15951574&link_type=MED&atom=%2Fdiaclin%2F24%2F1%2F35.atom [4]: /lookup/external-ref?access_num=000229798900003&link_type=ISI