Treat Gestational Diabetes for Baby's Sake
Study Shows Treatment of Diabetes in Pregnant Women Cuts Health Risks for Infants
Sept. 30, 2009 -- Treating pregnant women who have even mild gestational
diabetes helps reduce the risk of complications in infants and the women's own
risk of blood pressure problems, according to a new study.
While gestational diabetes -- defined as having glucose intolerance that
first shows up during a pregnancy -- has long been known to increase the risk
of the woman getting diabetes later in life, the risk of ill effects on the
pregnancy has not been as clear. Those women whose blood sugar levels are very
elevated appear to be at risk of complications, but how the milder form of
gestational diabetes affects the pregnancy has not been known exactly, the
The new study finding ''provides the evidence to endorse screening and
treating women even with mild gestational diabetes," says Catherine Spong, MD,
chief of the pregnancy and perinatology branch of the Eunice Kennedy Shriver
National Institute of Child Health and Human Development at the National
Institutes of Health, and a co-author of the study. It is published in the
New EnglandJournal of Medicine.
Up to 14% of U.S. pregnancies are affected by gestational diabetes,
according to the researchers.
In the study, Spong and colleagues, with lead investigator Mark Landon of
The Ohio State University Medical Center, Columbus, randomly assigned 485
pregnant women with mild gestational diabetes to the treatment group and 473 to
the comparison group. The women were cared for at 15 different medical
To qualify for the study, women were in the 24th to 31st week of pregnancy
and had a diagnosis of mild gestational diabetes. For the study, researchers
defined mild gestational diabetes as having a fasting glucose level of less
than 95 milligrams per deciliter and having at least two of three timed glucose
measurements taken one hour, two hours, and three hours after drinking a sugary
beverage that exceeded established thresholds.
Gestational diabetes is believed to occur in some women after increased
levels of some hormones that rise during pregnancy hamper the ability of
insulin to manage blood sugar. When blood sugar levels rise too much, it can
adversely affect the baby, causing it to grow too big, among other potential
The comparison group received usual prenatal care; two women in that group
needed insulin to control blood sugar levels.
Women in the treatment group were advised to exercise and received
nutritional counseling, learning how to spread their carbohydrate consumption
throughout the day to better regulate blood sugar levels, Spong tells WebMD.
They then monitored their blood glucose levels at home to be sure the diet
therapy helped keep blood sugar within the desired target range. Of the
treatment group, 93% managed with diet alone, while 7% needed insulin
injections to control their blood sugar.
The researchers then compared the outcomes of the two groups.