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Treat mild diabetes in pregnancy, study suggests

September 30, 2009 |  2:00 pm

Diabetes

Even women with mild gestational diabetes should receive treatment to improve the health of both mother and baby, according to a federally funded study that should help resolve a longstanding controversy in obstetrics.

Rates of gestational diabetes have been increasing as more U.S. women enter pregnancy overweight. Moderate-to-severe cases of the condition are always treated, but there has been uncertainty among doctors on whether women with mild increases in blood-sugar levels warrant additional care.

"Healthcare providers do not wish to overtreat women or unnecessarily alarm them, nor do they wish to impose extra costs, including self-glucose monitoring," said Dr. Mark Landon, lead investigator and interim chair of obstetrics and gynecology at Ohio State University Medical Center.

The study, published in the New England Journal of Medicine, assigned 958 women with mild gestational diabetes, who were between 24 and 31 weeks’ pregnant, to receive either diabetes treatment or no treatment. The women who received treatment were counseled on diet and glucose monitoring and, if necessary, received insulin.

 Most of the babies in both arms of the study were born at normal weights. However, in the treatment group, 7.1% of infants were too large — defined as at or above the 90th percentile — compared with 14.5% in the untreated group. Babies in the treated group were less likely to be born via Cesarean section or to suffer trauma at birth.

Women in the treated group gained less weight during pregnancy, had fewer preterm births and fewer cases of preeclampsia, a sudden increase in blood pressure. The study was conducted at 14 sites and funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

-- Shari Roan

Photo: Los Angeles Times

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