Can a diagnosis of gestational diabetes be an advantage to the outcome of pregnancy?
OBJECTIVE
We examined the obstetric outcomes of 138 treated women with gestational diabetes mellitus (GDM) compared with 144 women who had a 2-hour, 75-g glucose tolerance test result of between 7.0 and 7.9 mmol/L (126 and 142 mg/dL, respectively).


METHODS
The subjects for this study were consecutive patients from a universal testing program for GDM during 1993. Gestational diabetes mellitus was diagnosed if the 2-hour plasma glucose level was 8.0 mmol/L (144 mg/dL) or greater after a 75-g glucose load in the fasting state.


RESULTS
Treated women with GDM had a macrosomia rate of 8.0%, which was significantly less (P < .02) than the rate of 17.4% in the "normal" women. Treated women with GDM had a 2.2% rate of fetuses weighing less than 2500 g, which was significantly lower (P = .05) than the 6.9% rate for normal women. Overall, insulin therapy was used in 23.2% of the women with GDM, and no insulin-treated woman had either a macrosomic fetus or a fetus weighing less than 2500 g.


CONCLUSIONS
Treated women with GDM, particularly those who receive insulin, have a more favorable fetal outcome than women who have a glucose result between 7.0 and 7.9 mmol/L (126 and 142 mg/dL). These results suggest that the current diagnostic criteria for GDM, with respect to fetal outcomes, may need revision, and an additional subgroup of pregnant women may benefit from dietary advice.
Moses
R G
RG
Diabetes Education Centre, Wollongong, Australia.
Griffiths
R D
RD
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin