title: Glycemic characteristics and neonatal outcomes of women treated for mild gestational diabetes.
abstract: OBJECTIVE
  To estimate the association between fasting and 2-hour postprandial blood glucose levels and neonatal outcomes in women treated for mild gestational diabetes.
  
  
  METHODS
  In this secondary analysis of a multicenter randomized treatment trial of mild gestational diabetes, the median fasting and 2-hour postprandial glucose levels were analyzed in 2-week intervals and change over time (slope) was calculated for women with gestational diabetes (abnormal oral glucose tolerance test) and a fasting glucose less than 95 mg/dL who received nutritional management with self blood glucose monitoring and insulin as needed. Regression analyses were performed to estimate the relationship between median fasting and postprandial glucose and neonatal fat mass, cord blood C-peptide, birth weight, large-for-gestational-age neonates, macrosomia (greater than 4,000 g), and neonatal hypoglycemia.
  
  
  RESULTS
  Among 460 women with gestational diabetes, median fasting (P<.001), postprandial breakfast (P<.001), and postprandial lunch (P<.001) glucose values declined over the treatment period, whereas postprandial dinner values remained stable (P=.83). Higher median fasting glucose during the first 2 weeks of treatment was significantly associated with increased odds ratios for neonatal fat mass (1.35; 95% CI 1.09-1.66; P=.006) and elevated C-peptide (1.29; CI 1.09-1.52; P=.003). Higher median fasting glucose during the last 2 weeks before delivery was associated with higher rates of large-for-gestational-age neonates (1.27; CI 1.05-1.53; P=.01), macrosomia (1.32; CI 1.04-1.65; P = .02), and elevated C-peptide (1.19; CI 1.03-1.38; P=.02).
  
  
  CONCLUSIONS
  In women treated for mild gestational diabetes, higher fasting glucose during initiation of diet therapy was associated with increased neonatal fat mass and elevated C-peptide and during the last 2 weeks before delivery with macrosomia, large-for-gestational age, and elevated C-peptide.
  
  
  METHODS
  II.
authors.affiliation: From the Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio; the University of Texas Health Science Center at Houston, Houston; Texas; the University of Utah, Salt Lake City, Utah; the University of Alabama at Birmingham, Birmingham, Alabama; Drexel University, Philadelphia, Pennsylvania; Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio; the University of Texas Medical Branch, Galveston, Texas; Wayne State University, Detroit, Michigan; Oregon Health & Science University, Portland, Oregon; The George Washington University Biostatistics Center, Washington DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
authors.forename: Celeste P
authors.initials: CP
authors.lastname: Durnwald
authors.forename: Lisa
authors.initials: L
authors.lastname: Mele
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Anthony
authors.initials: A
authors.lastname: Sciscione
authors.forename: Patrick
authors.initials: P
authors.lastname: Catalano
authors.forename: George
authors.initials: G
authors.lastname: Saade
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Tolosa
authors.forename: Brian
authors.initials: B
authors.lastname: Casey
authors.forename: Garland D
authors.initials: GD
authors.lastname: Anderson
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D002096:C-Peptide / Q000097:blood; D016640:Diabetes, Gestational / Q000097:blood* / Q000178:diet therapy* / Q000188:drug therapy; D005215:Fasting / Q000097:blood; D005260:Female; D005865:Gestational Age; D005951:Glucose Tolerance Test; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D016017:Odds Ratio; D019518:Postprandial Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D012044:Regression Analysis; D018570:Risk Assessment; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007004:Hypoglycemic Agents; D007328:Insulin