title: Very tight versus tight control for diabetes in pregnancy.
abstract: BACKGROUND
  Pregnancies complicated by pre-existing insulin dependent diabetes are high risk for a number of poor pregnancy and neonatal outcomes.
  
  
  OBJECTIVE
  The objective of this review was to assess the effects of very tight glycaemic control in established insulin dependence.
  
  
  METHODS
  The Cochrane Pregnancy and Childbirth Group trials register was searched.
  
  
  METHODS
  Randomised trials comparing very tight with tight control of diabetes in pregnancy.
  
  
  METHODS
  One reviewer assessed trial quality and extracted data.
  
  
  RESULTS
  Two trials involving 182 women were involved. The two trials were difficult to compare. Maternal hypoglycaemia was more common among women whose diabetic control was very tight compared to tight control (odds ratio 25.96, 95% confidence interval 4.91 to 137.26) based on one trial. There was no difference detected in perinatal outcome between the groups.
  
  
  CONCLUSIONS
  There appears to be no clear evidence of benefit from very tight glycaemic control for pregnant diabetic women. Since very strict control may have a substantial impact on lifestyle, this suggests caution in advising such a degree of control.
authors.affiliation: Fetal Centre, Liverpool Women's Hospital NHS Trust, Crown Street, Liverpool, UK, L8 7SS. swalki@yahoo.com
authors.forename: S A
authors.initials: SA
authors.lastname: Walkinshaw
mesh_terms: D001786:Blood Glucose; D003922:Diabetes Mellitus, Type 1 / Q000517:prevention & control*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000517:prevention & control*
chemical_list: D001786:Blood Glucose