01 October 2009

Good to treat pregnancy diabetes

Treating even mild diabetes that develops during pregnancy helps keep moms and babies from gaining too much weight and makes for easier deliveries, new research shows.

Treating even mild diabetes that develops during pregnancy helps keep moms and babies from gaining too much weight and makes for easier deliveries, new research shows.

Pregnant women are routinely tested and treated for high blood sugar levels, although it hasn't been clear whether treating the mildest cases really benefited them and their infants.

In a study of 950 women, those with mild gestational diabetes who were treated had fewer overly large babies, fewer caesarean sections and fewer pregnancy complications, compared to women who didn't have their diabetes treated.

"There is every reason to fully treat women with even the mildest (gestational diabetes) based on our results," said the study's leader, Dr Mark Landon of Ohio State University Medical Centre in Columbus.

Gestational diabetes risk factors
Gestational diabetes begins during pregnancy and usually goes away after childbirth. It affects as many as one in seven pregnant women, depending on the population. The mother's elevated blood sugar can cause the foetus to grow too large, sometimes requiring a C-section and can bring on other health problems for the mother and baby.

Risk factors include being over 25, being obese and a family history of diabetes.

Medical groups support testing pregnant women for the condition

and treatment, although the US Preventive Services Task Force, a government health panel, said last year there wasn't enough evidence to recommend screening.

Landon said he'd had doubts about treating mild cases, and was surprised by the study's results.

"I did it, yet I wondered, 'Was I overtreating?"' he said.

Fewer complications with treatment
For the government-funded study, 958 women with mild gestational diabetes were recruited at 15 medical centres. They got either diabetes treatment or standard prenatal care. Treatment included diet counselling and insulin if needed to get their blood sugar under control.

In the treatment group, there were fewer babies of unusually large size (7% vs. 15% in the untreated group) and fewer babies weighed more than about 4kg (6% vs. 14%). On average, the treated women gained 2.3 fewer kilograms after their diagnosis than the untreated ones.

There were also fewer C-sections and cases of preeclampsia, a serious pregnancy complication. There were no deaths in either group, and no difference in other birth-related complications.

Landon noted that a "remarkable" 93% of the women in the treatment group kept their blood sugar under control with diet alone; only 7% needed insulin.

The findings are reported in the New England Journal of Medicine.

Dr David Sacks of Kaiser Foundation Hospital in Bellflower, California, said switching to a healthier diet could help other pregnant women limit weight gain, too. More large babies are born to overweight or obese women who don't have diabetes, he said.

"This is a real easy therapy to apply to every single pregnant lady," said Sacks, who wrote an editorial about the study in the journal.

(Sapa-AP, October 2009)

Read more: Gestational diabetes


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Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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