June 13, 2005
Treating Pregnancy-related Diabetes Is a Win-win for Mother and Baby
A major international study coordinated from Adelaide, South Australia has shown that treating pregnant women who develop mild gestational (pregnancy-related) diabetes helps their babies and improves the mother's health-related quality of life without increasing the risk of caesarean section.
Study leader Professor Caroline Crowther from the University of Adelaide Dept of Obstetrics and Gynaecology, based at the Women's and Children's Hospital, says that until now there has been uncertainty whether screening and treatment of mild gestational diabetes to reduce maternal glucose levels, reduces the risk for the babies. In addition, there has also been concern that such treatments may increase the risks of caesarean birth and an induced labour, and increase the risk of maternal anxiety and depression.
"There has been a lack of data from well-designed, large randomised clinical trials on the effects of screening and subsequent treatment of women with mild gestational diabetes," Prof Crowther said.
"Our results show that treatment for these women in the form of dietary advice, blood glucose checks and insulin, if required, is beneficial for both the mothers and their babies.
"Care strategies to improve health of women and babies need appropriate evaluation in large, often multicentered clinical trials to be certain they do more good than harm.
"Our trial known as the ACHOIS - Australian Carbohydrate Intolerance Study - is the largest in the world to date, with 1000 women and 1030 babies recruited, and involving 14 hospitals in Australia and four in the United Kingdom," Prof Crowther said.
Gestational diabetes affects between two and nine percent of all women in pregnancy. For the women, having gestational diabetes is a strong risk factor for developing diabetes in later life. Risks for the baby of having a mother with mild gestational diabetes include being larger than average at birth which may lead to difficulties during birth and birth injuries.
The trial was designed by a group of researchers from the University of Adelaide departments of Obstetrics and Gynaecology and Public Health, together with Perinatal Medicine, Women's and Children's Hospital and Medicine, Lyell McEwin Health Service.
The results will be presented on June 13th at the American Diabetes in Pregnancy Meeting in San Diego, USA and published on June 16th in the New England Journal of Medicine.
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