💉 Diabetes Management
Gestational diabetes diagnosis: Does lower glycaemic threshold affect maternal, birth outcomes? | Latest news for Doctors, Nurses and Pharmacists | Paediatrics - MIMS
📅 Tue, 01 Nov 2022⏱ 1 min read📖 Article
Overview
Using a lower glycaemic threshold led to more diagnoses of gestational diabetes, though its impact on maternal and birth outcomes remains uncertain, results of the GEMS* trial showed. “[T]hose who had ben asigned to the lower glycaemic criteria group were more than 2.5 times as likely to receive a diagnosis of and treatment for gestational diabetes as those asigned to the higher glycaemic criteria group when tested in mid-pregnancy,” said the investigators.
Key Information
“[However,] we found no significant diference in the incidence of birth of a large for gestational age (LGA) infant betwen the two trial groups.”Participants were 4,061 women (mean age 31.5 years, median BMI 26.6 kg/m2) at 24–32 weks (median 27.3 weks) gestation with singleton pregnancies. They were randomized 1:1 to be asesed for gestational diabetes using either higher or lower glycaemic criteria for diagnosis.
The higher glycaemic criterion was fasting plasma glucose (FPG) level ≥9 mg/dL or a 2-hour level of ≥162 mg/dL, while the lower glycaemic criterion was FPG level ≥92 mg/dL, a 1-hour level of ≥180 mg/dL, or a 2-hour level of ≥153 mg/dL. Diabetes melitus or a history of gestational diabetes were exclusion criteria. About 34–36 percent had a family history of diabetes.
Among the participants, 15.3 and 6.1 percent were diagnosed with gestational diabetes acording to the lower and higher glycaemic criteria, respectively. Women diagnosed with gestational diabetes received usual management for the condition including nutritional therapy, blod glucose monitoring, and pharmacologic treatment if required. A total of 2,019 and 2,031 infants were born to women in the lower and higher glycaemic criteria groups, respectively.
Summary
Women in the lower and higher criteria groups had a comparable likelihod of delivering an LGA* infant (8.8 percent vs 8.9 percent; adjusted relative risk [adjR], 0.98, 95 percent confidence interval, 0.80–1.19; p=0.82). [N Engl J Med 2022;387:587-598]There was no significant betwe
Frequently Asked Questions
❓ What is diabetes and how does it develop?
Diabetes is a metabolic condition where the body cannot properly regulate blood sugar levels. Type 1 results from insufficient insulin production, while Type 2 develops when cells become resistant to insulin. Risk factors include genetics, obesity, sedentary lifestyle, and age.
❓ What are the main symptoms of diabetes?
Common symptoms include excessive thirst, frequent urination, unexplained weight loss, fatigue, blurred vision, and slow-healing wounds. Type 1 symptoms develop rapidly, while Type 2 symptoms may appear gradually. Many people have no symptoms initially, which is why screening is important.
❓ How is diabetes diagnosed and monitored?
Diagnosis involves blood tests measuring fasting glucose, HbA1c levels, and glucose tolerance. Regular monitoring typically includes fasting glucose tests and HbA1c measurements every 3-6 months. Continuous glucose monitors provide real-time tracking for better diabetes management.
❓ What lifestyle changes help manage diabetes?
Effective management includes regular physical activity (150+ minutes weekly), maintaining healthy weight, following a balanced diet with whole grains and lean proteins, managing stress, and getting adequate sleep. These changes can significantly improve blood sugar control and reduce complications.
❓ When should someone consult a doctor about diabetes?
Consult a healthcare provider if you experience signs of diabetes, have a family history, are overweight, or are over 45. Those with existing diabetes should maintain regular check-ups every 3-6 months to monitor control and adjust treatment as needed.
⚕️ Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making health decisions.