Pregnancy: High-Normal Blood Sugar Risky
Experts Question Whether Gestational Diabetes Limit Is Too High
Who Should Be Treated? continued...
And while C-section rates increased with increasing blood sugar in the HAPO study, the increase was modest. Treatment to lower blood sugar levels was found to have no impact on C-section deliveries in a similar study of pregnant women with high-normal blood sugar.
"Until trials show clinical benefits for expanding the diagnostic criteria for 'gestational diabetes,' we would not favor any change," Ecker and Greene write.
Next month, an internationally representative group of diabetes, pregnancy, and public health experts will meet in Pasadena, Calif., to make their own assessment.
"Right now, there is a total lack of agreement about what should be called gestational diabetes and who should be treated," HAPO project manager Lynn P. Lowe, PhD, of Northwestern University tells WebMD.
Is Metformin Safe?
There is also confusion about which blood sugar-lowering therapies are best for the treatment of gestational diabetes.
Insulin is often recommended when diet and exercise alone fail to lower blood sugar, but use of the widely prescribed diabetes drug metformin during pregnancy remains controversial.
In a separate study also reported in Thursday's New England Journal of Medicine, researchers compared outcomes in 751 women with gestational diabetes treated with either insulin or metformin.
Researcher Janet A. Rowan, MB, and colleagues reported no increase in complications among infants born to mothers who took metformin.
But almost half (46%) of the metformin-treated women ended up needing supplemental insulin.