Average Fasting Blood Glucose Research Articles

Effects of Different Blood Glucose Levels on Critically Ill Patients in an Intensive Care Unit

Aims: We explore the infection incidence and possible prognostic outcome relevance for patients with different blood glucose levels in an intensive care unit (ICU). Methods: A total of 98 cases were enrolled and divided into three groups based on average fasting blood glucose levels (group A: ≤6.1 mmol/l; group B: 6.1-10 mmol/l; group C: ≥10 mmol/l). Results: There were no statistical differences in the time to ICU admission, the indwelling durations of gastric tubes, urinary or deep vein catheters, tracheal intubations and tracheotomies, or the length of ventilator use (all p > 0.05). No evident difference in the multiple organ dysfunction syndrome rate was found between the three groups (p = 0.226). The infection and mortality rates between the groups showed significant differences (all p < 0.05). Furthermore, the difference of respiratory system infections was statistically significant among the three groups (p = 0.008), yet no such statistical difference was observed among groups regarding nonrespiratory system infections (p = 0.227). Conclusions: Critically ill patients with a high blood glucose level were positively correlated with a relatively high APACHE II score and more serious degree of disease, as well as a higher incidence of respiratory infection during their ICU stay than those with lower blood glucose levels (<10 mmol/l).

Diabetic Patients' Knowledge of Their Disease, Therapeutic Goals, and Self-management: Association With Goal Attainment at Dessie Referral Hospital, Ethiopia.

This study aims to assess diabetic patients' knowledge of their disease, therapeutic goals, self-management, and its association with goal attainment at a hospital in Ethiopia. A prospective cross-sectional study was conducted from February to March 2012 at the diabetic follow-up clinic of Dessie Referral Hospital. Diabetic patients who came for their diabetic follow-up were included consecutively until a calculated sample size of 303 was obtained. Data were collected by face-to-face interview through a pretested structured questionnaire and by medical record review. Binary logistic regression analysis was used to determine predictors of fasting glycemic control. Ninety-nine patients (32.7%) had poor knowledge about their disease. The average fasting blood glucose was 226.57 ± 85.86 mg/dL, and only 61 patients (20.1%) achieved the recommended fasting glycemic goal (70-130 mg/dL). Diabetic patients who had poor knowledge were 5.53 times (95% confidence interval [CI]: 1.85, 16.49) more likely to not attain fasting glycemic goal compared to those who had good knowledge. Patients who did not practice self-monitoring of blood glucose were 3.09 times (95% CI: 1.33, 7.21) more likely to not attain fasting glycemic goal than those who practiced. Failure to achieve fasting glycemic goal was 2.43 times (95% CI: 1.15, 5.13) more common among patients who did not regularly exercise as compared to those who did. Patients who did not adhere to their medication were 3.72 times (95% CI: 1.69, 8.20) more likely to fail to achieve fasting glycemic goal compared to those who adhered to their medication. Fasting glycemic control was below the recommended standard among the study participants. Glycemic control was poor among patients who had poor knowledge, did not practice self-monitoring of blood glucose, did not participate in regular exercise, and were nonadherent to their medication. This study population had poor knowledge about their disease.

DNA aptamer raised against advanced glycation end products (AGEs) improves glycemic control and decreases adipocyte size in fructose-fed rats by suppressing AGE-RAGE axis.

Advanced glycation end products (AGEs) decrease adiponectin expression and suppress insulin signaling in cultured adipocytes through the interaction with a receptor for AGEs (RAGE) via oxidative stress generation. We have recently found that high-affinity DNA aptamer directed against AGE (AGE-aptamer) prevents the progression of experimental diabetic nephropathy by blocking the harmful actions of AGEs in the kidney. This study examined the effects of AGE-aptamer on adipocyte remodeling, AGE-RAGE-oxidative stress axis, and adiponectin expression in fructose-fed rats. Although AGE-aptamer treatment by an osmotic mini pump for 8 weeks did not affect serum insulin levels, it significantly decreased average fasting blood glucose and had a tendency to inhibit body weight gain in fructose-fed rats. Furthermore, AGE-aptamer significantly suppressed the increase in adipocyte size and prevented the elevation in AGEs, RAGE, and an oxidative stress marker, 8-hydroxydeoxyguanosine (8-OHdG), levels in adipose tissues of fructose-fed rats at 14-week-old, while it restored the decrease in adiponectin mRNA levels. Our present study suggests that AGE-aptamer could improve glycemic control and prevent adipocyte remodeling in fructose-fed rats partly by suppressing the AGE-RAGE-mediated oxidative stress generation. AGE-aptamer might be a novel therapeutic strategy for fructose-induced metabolic derangements.

Evaluation of the safety and efficacy of primary total knee arthroplasty in patients with diabetes

Objective To evaluate the perioperative safety and clinical efficacy of primary total knee arthroplasty in patients with diabetes.Methods Among the patients who were treated with total knee arthroplasty,there were 148 patients (168 knees) associated with diabetes.There were 32 male (36 knees) and 116 female (132 knees),the average age was 67.2 years (range,49-80 years).Osteoarthritis was diagnosed in 136 patients and rheumatoid arthritis was diagnosed in 12 patients.Different degrees of preoperative knee deformities were found in 116 knees.The average fasting blood glucose was 10.1±4.9 mmol/L at the admission time.The glycemic goals was set as:fasting blood glucose ＜ 7.8,2 h postpradndial blood glucose ＜ 10 mmol/L.Results After regular regulating of the blood glucose,the average preoperative fasting blood glucose was 7.2± 1.2 mmol/L,up to 9.9mmol/L.The average postprandial blood glucose was 11.0± 1.8 mmol/L.The mean duration of surgery was 72± 19 min,intraoperative blood loss was few and the mean drainage volume was 213.1±101.0 ml.The average total blood loss was 771.4±97.2 ml.Transfusion was needed in 12 patients (8.1％).Calf muscle venous thrombosis was found in 5 patients,while no deep vein thrombosis was found.The average length of stay was 13.0±4.4 days and the average follow-up time was 9.4±2.9 months.At the final follow-up time point,no prosthesis loosening was found and no revision was needed in any patients.The mean HSS scores increased from the preoperative 38.8± 14.3 to the postoperative 92.1±6.1,the excellent rate was 100％.The knee range of motion raised from preoperative 77.2°±19.3° to the postoperative 109.9°±11.1°.No deep infection was found.Conclusion Diabetic patients do not seem to have a significantly higher risk for infection and DVT after TKA.The early clinical outcomes of the patients with diabetes were satisfied.A comprehensive assessment of perioperative cardiopulmonary conditions should be conducted and active prevention of deep vein thrombosis and infection should be performed. Key words: Arthroplasty, replacement, knee; Diabetes mellitus; Perioperative period

Empirically Establishing Blood Glucose Targets to Achieve HbA1c Goals

OBJECTIVETo determine the average fasting, postprandial, and bedtime self-monitored blood glucose (SMBG) concentrations associated with specified HbA1c levels using data from the A1c-Derived Average Glucose (ADAG) study.RESEARCH DESIGN AND METHODSThe ADAG study was a multicenter observational study that used continuous glucose monitoring and SMBG testing to determine the relationship between mean average glucose and HbA1c. We used the SMBG data from 470 of the ADAG study participants (237 with type 1 diabetes and 147 with type 2 diabetes) to determine the average fasting, premeal, 90-min postmeal, and bedtime blood glucose (BG) for predefined target HbA1c groups between 5.5 and 8.5% (37–69 mmol/mol). t Tests were used to compare mean BG values between type 1 and type 2 diabetes groups.RESULTSThe average fasting BG needed to achieve predefined HbA1c target levels of 5.5–6.49% (37–47 mmol/mol), 6.5–6.99% (48–52 mmol/mol), 7.0–7.49% (52–58 mmol/mol), 7.5–7.99% (58–64 mmol/mol), and 8.0–8.5% (64–69 mmol/mol) were 122 mg/dL with 95% CI 117–127, 142 mg/dL (135–150), 152 mg/dL (143–162), 167 mg/dL (157–177), and 178 mg/dL (164–192), respectively. Postmeal BG to achieve the HbA1c level of 6.5–6.99% (48–52 mmol/mol) and 7.0–7.49% (52–58 mmol/mol) were 139 mg/dL (134–144) and 152 mg/dL (147–157), respectively. Bedtime BG was 153 mg/dL (145–161) and 177 mg/dL (166–188), respectively.CONCLUSIONSWe have determined the average BG at premeal, postmeal, and bedtime to achieve a variety of HbA1c targets. These results, based on empirical data, will help patients and providers set realistic day-to-day SMBG targets to achieve individualized HbA1c goals.

Profile of fasting blood glucose in obese children with insulin resistance

Results There were 54 obese children, mean age 12.2 (11.9 to 12.5) years. Thirty seven (68.5%) boys and 17 (31.5%) girls. With 34 children (63%) had insulin resistance: 23 (67.6%) male sex, and 11 (32.4%) girls, 18 (52.9%) no history of diabetes mellitus in families and 16 (47.1%) were found in the family history of diabetes mellitus. The average fasting blood glucose level on average obese children with insulin resistance is higher than obese children without insulin resistance at 5.08 (4.9 to 5.2) mmol / L compared with 4.79 (4.6 to 4, 9), (p <0.003) mmol / L. Fasting Blood Glucose Level in obese children with insulin resistance was significantly higher than obese children who did not have insulin resistance. Conclusion The data from this study showed that the level of fasting blood glucose in obese children who had insulin resistance is higher than obese children without insulin resistance.

Beneficial Effects of Vildagliptin on Retinal Injury in Obese Type 2 Diabetic Rats

Background/Aims: Vildagliptin is an oral inhibitor of dipeptidyl peptidase-4, an enzyme mainly responsible for inactivating incretins, and one of the widely used drugs for the treatment of type 2 diabetes. However, effects of vildagliptin on retinal injury in diabetes remain unclear. We examined here whether oral administration of vildagliptin inhibited gene expression of inflammatory and thrombogenic parameters in Otsuka Long-Evans Tokushima Fatty rats (OLETF rats), an animal model of obese type 2 diabetes. Methods: OLETF rats at 22 weeks of age were given vehicle or 3 mg/kg of vildagliptin for another 10 weeks. Gene expression was analyzed in quantitative real-time reverse transcription-polymerase chain reaction. Results: Vildagliptin significantly inhibited the increase in body weight and decreased average fasting blood glucose in the OLETF rats. Compared with 22-week-old OLETF rats, gene expression levels of vascular endothelial growth factor, intercellular adhesion molecule-1, plasminogen activator inhibitor-1 and pigment epithelium-derived factor were significantly increased in the retinas of OLETF rats at 32 weeks of age, all of which were inhibited by treatment with vildagliptin. Conclusions: The present study demonstrated for the first time that vildagliptin inhibited inflammatory and thrombogenic reactions in the retinas of obese type 2 diabetic rats. Vildagliptin may play a protective role against diabetic retinopathy.

PROTECTIVE EFFECTS OF ERYTHROPOIETIN ON CARDIAC FUNCTION IN DIABETIC RATS

ObjectivesTo investigate the protective effects of erythropoietin on cardiac function of diabetic rats and its mechanismMethodsForty-five male SD rats (180–200 g) were randomly divided into three groups: normal control (CON,...

Features of social adaptability and autonomic stability of adolescents with metabolic syndrome

Aim. To identify the features of social adaptability and autonomic stability of adolescents with metabolic syndrome. Methods. The parameters of social adaptation and autonomic stability of 300 obese adolescents were studied. The main group included 150 adolescents (mean age 14.0±0.12 years) who were diagnosed with metabolic syndrome. The comparison group consisted of 150 adolescents (mean age 13.9±0.14 years) with primary uncomplicated obesity. A two-factor personality questionnaire of M. Gavlinova («society - autonomic nervous system») was used. Anthropometric indices (body weight, body mass index, height, waist circumference, hip circumference, waist/hip circumference ratio) were evaluated, the blood pressure was measured. General and biochemical blood tests and urine tests were performed (determination of the level of glucose, insulin, triglycerides, cholesterol, lipoproteins of high and low density, uric acid), as well as instrumental investigations. Results. In the group of adolescents with metabolic syndrome the mean body mass index 29.21±0.37 was significantly higher (p 0.001) compared to 26.07±0.46 in the group of patients with uncomplicated obesity. The waist/hip circumference ratio was significantly higher in adolescents with metabolic syndrome: 0.89±0.41 vs. 0.80±0.12 in the control group. In 92.71% of adolescents with metabolic syndrome arterial hypertension was diagnosed. In adolescents of the first group found were and laboratory markers of the metabolic syndrome: dyslipidemia in the form of hypertriglyceridemia (2.04±0.08 mmol/l) and decrease of the concentration of high-density lipoproteins (1.1±0.04 mmol/l). The average fasting blood glucose level was 5.78±0.02 mmol/l, the index of the model of homeostasis assessment for insulin resistance was 6.64±0.21. In the group of adolescents with metabolic syndrome the average score on the scale of social adaptation was low (8.48±0.13), whereas in the group without metabolic syndrome it was 13.51±0.22, which was significantly higher than in the main group (p 0.001), and was evidence of normal social adaptation. Low level of social adaptation was observed more frequently in girls than boys in both groups. Established was a correlation between the body mass index and social adaptability (r=-0.358), and with autonomic stability (r=0.378), p 0.05. Conclusion. Social adaptability and autonomic stability of adolescents with metabolic syndrome depend on the severity of clinical and metabolic changes and on the sex, thus this must be taken into account during treatment and rehabilitation.

The effect of weight loss on fasting blood sugars and hemoglobin A1c in overweight and obese diabetics and non-diabetics

BACKGROUND: Diet and exercise are recommended first line treatment for overweight, obese, and diabetic patients with the goal of decreasing weight and improving glycemic control. The goal of this study was to determine the effect that a low calorie diet and behavioral modification program, as implemented by a medically supervised weight loss program, would have on the fasting blood sugar and hemoglobin A1c in overweight or obese diabetic and over-weight or obese non-diabetic participants. METHODS: Charts from 2009 to 2010 were reviewed for 310 diabetic and non-diabetic patients enrolled in the Via Christi Weight Management (VCWM) program in Wichita, Kansas. Data were collected before and after patients underwent a program of meal replacements and weekly physical activity lasting 12 weeks. Variables included pre and post treatment fasting blood sugars, hemoglobin A1c, body mass index, percent body weight lost, and diabetes status. RESULTS: Diabetic participants lost an average of 11.7% of their initial body weight (IBW), and non-diabetic patients lost 12.5% of their IBW over the treatment course. Post-treatment average fasting blood glucose (FBG) decreased in both diabetics and non-diabetics by 15.53 mg/dL and 8.46 mg/dL, respectively (p = 0.08). Diabetic patients experienced a significant decrease of 0.83% from pre to post-treatment in hemoglobin A1c. For diabetic and non-diabetic groups, the changes in FBG were correlated with the change in weight. CONCLUSIONS: Diet and exercise, as prescribed by the VCWM program, is effective in reducing hemoglobin A1c in diabetics and reducing fasting blood sugars in both diabetic and non-diabetic patients.

Exenatide Pretreatment Improved Graft Function in Nonhuman Primate Islet Recipients Compared to Treatment after Transplant Only

The GLP-1 receptor agonist, exenatide, has previously been shown to improve insulin secretion, protect beta cells from apoptosis, and promote beta cell regeneration. We propose that pretreatment with exenatide will promote islet graft survival and improve graft function. Pancreatectomized cynomolgus monkeys underwent islet allotransplantation and were treated with exenatide beginning on day 0 or day −2. A third group of animals was treated with an immunosuppressive regimen while a fourth group remained untreated. Fasting blood glucose (FBG) was used to evaluate graft function along with intravenous glucose tolerance tests (IVGTTs) performed at study endpoint (day 10 for untreated and posttransplant exenatide or day 90 for pretreatment exenatide and immunosuppression). The average FBG for pre-treated animals day 5 following transplant was 52.7 ± 14.8 mg/dl, compared to 154.3 ± 105.5 mg/dl for animals treated only following transplant, 59.4 mg/dl ±12.1 for animals treated with immunosuppression, and 265.5 ± 172.3 mg/dl for untreated animals. IVGTTs performed at study endpoint showed normal glucose and insulin curves in the pre-treated exenatide and immunosuppression groups only, with beta cell function actually improving after transplant in the pre-treated group. We conclude, therefore, that exenatide pre-treatment can successfully maintain islet graft survival in nonhuman primates.

Converse contributions of fasting and postprandial glucose to HbA1c and glycated albumin

Objective We evaluated the relationship between glycated hemoglobin (HbA1c) in diabetic patients with stable glycemic control and the average fasting blood glucose (FBG) and postprandial blood glucose (PPG) values of 4 weeks prior to HbA1c measurement and compared the results with glycated albumin (GA).

P2-326 Comparison of urban diabetics with optimal and suboptimal control

IntroductionThe prevalence of Diabetes Mellitus in Sri Lanka is increasing. We describe the characteristics of patients with optimal and suboptimal control of diabetes among known diabetics in a 35–64-year-old urban...

Steroid-free maintenance of islet allografts using mycophenolate mofetil and cyclosporine in the non-human primate

Islet transplantation continues to be a promising treatment for type 1 diabetes, however, numerous limitations still prevent its widespread use. Many immunosuppressive medications used for islet transplantation are known to be diabetogenic. The goal of this study is to evaluate the short-term follow-up (90 day) of a steroid-free maintenance immunosuppression protocol of mycophenolate mofetil (MMF) and cyclosporine (CSA) in non-human primate islet allotransplantation. Diabetes was induced in the primate Macaca fascicularis via total pancreatectomy. Freshly isolated islets were autotransplanted (n=5) or allotransplanted (n=5) into the portal vein. Immunosuppression consisted of induction with rabbit anti-thymocyte globulin (ATG) and prednisone. CSA (25 mg/daily) and MMF (250 mg daily) were used for maintenance and given orally once daily throughout the 90 day study period. Fasting blood glucose measurements were used to monitor graft function. Intravenous glucose tolerance tests (IVGTT) were performed prior to pancreatectomy and at the study endpoint. Average fasting blood glucose levels were elevated in diabetic controls (313.6 mg/dl ±51.8) and untreated allograft recipients (257 mg/dl ±61.0) post-transplant. Auto-transplanted animals and allograft recipients treated with immunosuppression, on the other hand, maintained normoglycemia (74.5 mg/dl ±20.9, 62.3 mg/dl ±4.40) throughout the follow-up period. Additionally, beta cell function and first phase insulin secretion did not differ significantly between auto-graft and immunosuppressed allo-graft recipients post-transplant. We conclude that this steroid-free maintenance immunosuppression regimen is effective in maintaining islet allograft survival in the non-human primate and offers comparable graft function to that of autografts for up to 3 months post-transplant.

The influence of a sequential-type oral contraceptive with ethinylestradiol-sulfonate soft gelatin capsules and norethisterone acetate on carbohydrate metabolism during the first twelve months.

A prospective study was made to investigate the carbohydrate metabolic effects of the sequential-type oral contraceptive in form of a weekly pill with 0.6 mg ethinylestradiol-sulfonate soft gelatin capsules and 10 mg norethisterone acetate. Blood glucose and plasma insulin levels were measured during an intravenous glucose tolerance test in 17 nondiabetic healthy women. Each woman was tested before and after twelve months of drug use. There were no changes neither in average fasting blood glucose nor in glucose assimilation after intake of ethinylestradiol-sulfonate. At twelve months there were significant elevations of basal as well as reactive insulin levels.

Clinical analysis of oral and maxillofacial spaces infections in diabetic patients:a report of 31 cases

The characterization and management of oral and maxillofacial spaces infections in diabetic patients were studied in order to determine the pattern of this clinical condition and formulate a management plan.There were 31 cases with average age of 61 years(s=9);the mean hospitalization time was 14 days(s=6);the average fasting blood glucose level on admission was 10.4 mmol/L.Of the 31 patients 20 were multiple-space infections and 11 were single-space infections.13 patients had major complications during admission.Odontogenic infection was the most common cause of the space infections.Streptococcus viridians and staphylococcus aureus were common organisms(5/19,4/19)identified through pus and/or blood cultures.Early surgical incision and drainage,perfect blood glucose control,intravenous antimicrobial therapy,preventing asphyxia and managing major complications are necessary and effective approaches for the management plan. Key words: Diabetes mellitus; Stomatognathic diseases

Dietary intake, capillary blood glucose, and activity level of activity-restricted, hospitalized, pregnant women in the third trimester: a pilot study

Activity restriction in hospital is commonly prescribed by care providers to decrease the incidence of maternal or fetal morbidity in high-risk pregnancies. The purpose of this pilot descriptive study was to collect preliminary data on dietary intake, capillary blood glucose concentrations, and activity level in high-risk, activity-restricted, pregnant women in the third trimester of pregnancy. Dietary food intake records, capillary blood glucose, and daily pedometer step totals were investigated in 20 activity-restricted women over 7 consecutive days in hospital. Subjects were asked to collect hospital meal tickets, as well as record any additional items not provided by the hospital in a dietary log each day. Capillary blood glucose was collected every morning (fasting) as well as 1 h after breakfast (post-prandial) using a glucometer. Subjects wore a pedometer 24 h/d, and recorded step totals 4 times daily in a pedometer log. In the analysis, average energy and macronutrient intakes met dietary reference intake (DRI) recommendations, as did average intakes of all micronutrients, including maternal supplementation. Without supplementation, vitamin E and iron intakes were lower (p<0.05) than the DRI recommendations. Average fasting (4.6+/-0.5 mmol/L) and post-prandial (7.1+/-1.0 mmol/L) blood glucose concentrations in subjects without gestational diabetes (GDM) did not exceed Canadian Diabetes Association cut-off values for screening of GDM. The mean daily step total of 1579+/-936 was lower than ambulatory third-trimester women (6495+/-2282 steps; p<0.001). Results from this pilot study suggest that with maternal supplementation, these activity-restricted, hospitalized, pregnant women were meeting dietary recommendations, and did not have elevated capillary blood glucose. However, given the severity of activity restriction, these women may be at risk for consequences of extreme inactivity.

The Impact of Glycemic Control on Neonatal Outcome in Singleton Pregnancies Complicated by Gestational Diabetes

To identify the impact of suboptimal blood glucose control on neonatal outcomes in women with gestational diabetes mellitus (GDM). Included were patients with singleton gestation enrolled in an outpatient GDM management program for at least 7 days who delivered at term. Blood glucose control was defined as an average fasting blood glucose of <95 mg/dl, 1-h postprandial of <140 mg/dl, or 2-h postprandial of <120 mg/dl. Data were compared between patients with optimal blood glucose control (n = 2,030) and those with suboptimal blood glucose control (n = 1,188). The primary study outcome was a composite variable consisting of macrosomia, large-for-gestational-age, hypoglycemia, jaundice, or stillbirth. Over one-third of infants in the poorly controlled group were positive for at least one factor comprising the composite variable compared with 24% from the controlled group (P < 0.001). Suboptimal glycemic control in women with GDM is associated with adverse neonatal outcome. Careful monitoring of blood glucose levels and initiation of appropriate treatment are essential in the care of women with GDM.

Feasibility and Safety of Insulin Pump Therapy in Children Aged 2 to 7 Years With Type 1 Diabetes: A Retrospective Study

Although insulin pump therapy has been successful in adults, adolescents and school children, its use has been limited in young children. The purpose of this study was to evaluate the glycemic control, safety and efficacy of continuous subcutaneous insulin infusion via pump in young children (2-7 years old) with type 1 diabetes who were transitioned from twice-a-day insulin injection (neutral protamine Hagedorn/Lente + Humalog/Novalog) to insulin pump therapy. Hemoglobin A1c, BMI, average fasting blood glucose, episodes of severe hypoglycemia, episodes of diabetic ketoacidosis, episodes of lipohypertrophy, blood glucose variability, and number of sick day calls were compared before and after insulin pump therapy. Data were collected retrospectively by chart review over a 2-year period during quarterly diabetes clinic visits from 33 patients who were managed on neutral protamine Hagedorn/Lente + Humalog/Novolog twice-a-day injections for at least 1 year prior to transitioning to insulin pump therapy. There was a significant improvement in the average hemoglobin A1c after continuous subcutaneous insulin infusion therapy. The average fasting blood sugar was lower in the continuous subcutaneous insulin infusion group. Severe episodes of hypoglycemia and episodes of lipohypertrophy were significantly higher before insulin pump therapy initiation. There were significantly fewer sick day calls after continuous subcutaneous insulin infusion. Blood sugar variability improved significantly after insulin pump therapy. There was no significant difference in BMI or amount of carbohydrate consumed. None of the patients experienced diabetic ketoacidosis requiring emergency treatment before or after insulin pump therapy. Continous subcutaneous insulin infusion therapy in young children with type 1 diabetes is a safe, effective and superior alternative to a twice-a-day insulin regimen.

The impact of glycemic control on neonatal outcome in singleton pregnancies complicated by gestational diabetes

To compare neonatal outcome in women diagnosed with gestational diabetes (GDM) whose average blood glucose (BG) values were within recommended guidelines to those with higher than recommended BG averages.