Treating Mild Gestational Diabetes Reduces Complications

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Until now, clinicians had no clear evidence that treating mild gestational diabetes could reduce common birth complications among infants and benefit mothers as well. The study was supported by the National Institutes of Health and the National Institute of Child Health and Human Development.

Gestational diabetes is a condition that affects 1 to 14 percent of pregnant women in the United States. It is characterized by the sudden development of high blood sugar levels in a pregnant women who had no signs or symptoms of diabetes before becoming pregnant. The cause is unknown, although a popular theory is that hormones produced by the mother during pregnancy disrupt the body’s ability to utilize insulin to absorb sugar from the blood.

Clinicians routinely treat any pregnant woman who had gestational diabetes, and treatment is known to benefit both mothers and infants in severe cases. According to the Mayo Clinic, complications associated with untreated or improperly treated gestational diabetes include an increased risk of having a very large baby (which may sustain injuries or require cesarean section), low blood sugar (which may cause infant seizures in severe cases), respiratory distress syndrome, type 2 diabetes later in life, and developmental disorders. Death can occur in rare cases.

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Gestational diabetes can also impact the mother. Complications include an increased risk of preeclampsia, which is characterized by high blood pressure and excess protein in the urine; urinary tract infections (twice the risk of pregnant women without gestational diabetes); and development of type 2 diabetes in the future.

In the current study, the researchers enrolled 958 women who had mild gestational diabetes. About half of the women (485) were treated for the diabetes and half (473) were not. Compared with women who were not treated, those who received treatment were half as likely to give birth to an unusually large infant, half as likely to experience shoulder dystocia (a critical situation in which the baby’s shoulder is lodged inside the mother’s body during birth); four-fifths as likely to need cesarean delivery; and three-fifth as likely to develop high blood pressure or preeclampsia.

The results of this study demonstrated clear benefits to mothers and their infants when mild gestational diabetes is treated. In most cases, treatment includes attention to diet and exercise to reduce blood sugar levels. If these efforts are not effective, diabetes drugs or insulin may be prescribed to control blood sugar levels and hopefully prevent any complications.

SOURCES:
Landon MB et al. New England Journal of Medicine 2009 Oct. 1; 361 (14): 1339-48
Mayo Clinic

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