Gestational diabetes, a condition that develops during pregnancy in which a woman's body has difficulty breaking down sugars, occurs in 2 to 9 percent of pregnant women and usually subsides after delivery. These women sometimes experience difficult labors and have an increased chance of developing Type II diabetes later in life. Babies born to these mothers are more likely to sustain birth injuries, become obese, and have impaired intellectual development. Doctors disagree on what treatment, if any, pregnant women with gestational diabetes should receive. To find out whether treatment could help both mothers and babies, Australian researchers gave dietary advice, training for blood sugar tests, and insulin, a hormone that helps regulate blood sugar, to pregnant women with the disease.
What the researchers wanted to know: Does treatment, including insulin, help pregnant women with gestational diabetes and their babies?
What they did: Researchers split a group of 1,000 pregnant women with gestational diabetes into two groups. Roughly half the women were told their diagnosis and received dietary advice, training for self-administered blood sugar tests, and insulin. Women in the other group remained unaware they had gestational diabetes and received normal care for an expectant mother. Researchers watched both groups of women and their babies for signs of difficult labor and birth injuries. For three months after delivery, researchers continued looking for complications associated with gestational diabetes in mothers, including depression and anxiety.
What they found: Babies of treated mothers had healthier weights at birth and were four times less likely to suffer from problems linked to gestational diabetes, including bone fractures and nerve palsy, than babies of mothers who received normal prenatal care. No babies in the treatment group were stillborn or died before leaving the hospital, while five babies were lost during that time in the normal care group. Rates of surgical delivery (cesarean section) were similar for both treated and untreated women. Fewer women who received treatment suffered from depression following delivery.
What this study means to you: Doctors usually recommend that pregnant women take a blood sugar test that can detect gestational diabetes between the 24th and 28th weeks of pregnancy. Expectant mothers who test positive should talk to their physicians about care options, which could include dietary changes, glucose monitoring, and insulin treatment.
Caveats: The authors of the study did not include women with severe forms of gestational diabetes. Also, the study did not determine the health effects of treatment for mothers or babies beyond three months after delivery. Several studies are currently underway that could contribute to knowledge about this condition.
Read the article: Crowther, C.A. et al. "Effect of Treatment of Gestational Diabetes Mellitus on Pregnancy Outcomes." New England Journal of Medicine. June 16, 2005, Vol. 352, No. 24, pp. 24772486.
Read the abstract: http://content.nejm.org