title: Comprehensive intensive therapy for Chinese gestational diabetes benefits both newborns and mothers.
abstract: OBJECTIVE
  This study identified the impact of intensive therapy on neonatal outcomes in women with gestational diabetes mellitus (GDM) and determined the effects on the postpartum metabolic status of the mothers.
  
  
  METHODS
  In total, 127 pregnant women with GDM were randomly selected to receive an intensive treatment regimen, which included one-to-one education, lifestyle intervention, scheduled clinic visits, strict glucose control, and frequent glucose self-monitoring. Meanwhile, 148 age-matched pregnant women with GDM were selected as controls and given the standard treatment regimen. Pregnancy outcomes including parameters related to the GDM mothers and to their neonates were comparatively analyzed between the two treatment groups. GDM patient follow-up (range, 1-3 years after delivery) included an oral glucose tolerance test and measurements of lipid concentration and insulin secretion. The insulinogenic index (ΔInsulin(30 min)/ΔBlood glucose(30 min)) and homeostasis model assessment index of β-cell function and insulin resistance were calculated. The patients' demographic and anthropometric data were also recorded for comparative analysis.
  
  
  RESULTS
  Compared with GDM patients receiving standard treatment, GDM patients receiving intensive treatment had lower instances of premature delivery (2.4% vs. 8.3%, P<0.05) and neonatal care unit admission (21.3% vs. 33.3%, P<0.05) and lower neonatal birth weight (3.26±0.53 vs. 3.45±0.55 kg, P<0.0001). At follow-up, GDM patients from the intensive treatment group had a smaller waist circumference (75.83±3.11 vs. 78.34±4.20 cm, P<0.01), lower 30-min glucose levels after a 75-g glucose load (8.26±1.85 vs. 9.46±2.74 mmol/L, P<0.05), and higher high-density lipoprotein levels (1.30±0.24 vs. 1.18±0.23 mmol/L, P<0.05).
  
  
  CONCLUSIONS
  The intensive GDM treatment regimen led to healthier outcomes for the women, the neonates, and the birth event and was associated with better maternal metabolic situations in the months and years after delivery.
authors.affiliation: Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Xiaopei
authors.initials: X
authors.lastname: Cao
authors.forename: Zilian
authors.initials: Z
authors.lastname: Wang
authors.forename: Chijiao
authors.initials: C
authors.lastname: Yang
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Mo
authors.forename: Lingling
authors.initials: L
authors.lastname: Xiu
authors.forename: Yangbing
authors.initials: Y
authors.lastname: Li
authors.forename: Haipeng
authors.initials: H
authors.lastname: Xiao
mesh_terms: D000328:Adult; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007231:Infant, Newborn; D007333:Insulin Resistance; D008297:Male; D009035:Mothers; D010353:Patient Education as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D040242:Risk Reduction Behavior
chemical_list: D001786:Blood Glucose