Early detection and treatment of gestational diabetes mellitus
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Reviewed & translated by Dat Tien Nguyen, B.A, ScM.
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Posted on July 12th, 2023
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Gestational diabetes is a commonly occurring complication and it can increase the risk of events that can negatively affect the health of both the mother and neonates. Mother had a higher risk of pre-eclampsia and the need of obstetrical intervention. The diabetes can also cause the fetus to grow larger than expected and increase the risk of shoulder dystocia and trauma. Screening and treatment are recommended at gestational week 24, which effectively lower the amount of adverse outcomes. So, a study was performed in Australia and New Zealand to investigate whether treatment at the 20th week can produce the same level of benefit.
The study included 802 women who are pregnant with only 1 fetus and are between their 4th and 19th gestational week. These women have at least one of the following risk factors for gestational diabetes: older than 40 years old, BMI above 30, had previously experienced gestational diabetes, polycystic ovary syndrome, or macrosomia. An oral glucose tolerance test was performed before these women reached the 20th gestational week, and diagnosis was made based on the standard set by the World Health Organization. These patients were randomly assigned to receive either immediate treatment upon testing at the 20th week, or delayed treatment to later. The researchers found that the immediate treatment significantly reduces the risk of adverse neonatal outcome by 5.6%. However, early detection and treatment did not reduce the incidence of pregnancy-related hypertension or the neonatal body mass.
The study included 802 women who are pregnant with only 1 fetus and are between their 4th and 19th gestational week. These women have at least one of the following risk factors for gestational diabetes: older than 40 years old, BMI above 30, had previously experienced gestational diabetes, polycystic ovary syndrome, or macrosomia. An oral glucose tolerance test was performed before these women reached the 20th gestational week, and diagnosis was made based on the standard set by the World Health Organization. These patients were randomly assigned to receive either immediate treatment upon testing at the 20th week, or delayed treatment to later. The researchers found that the immediate treatment significantly reduces the risk of adverse neonatal outcome by 5.6%. However, early detection and treatment did not reduce the incidence of pregnancy-related hypertension or the neonatal body mass.