title: The benefit of early treatment without rescreening in women with a history of gestational diabetes.
abstract: OBJECTIVE
  In this center, women with a history of gestational diabetes (GDM) are treated without rescreening from early pregnancy in any subsequent pregnancies, commencing with a low glycemic diet and insulin if and when indicated. The objective of this study was to see if this practice reduced the incidence of macrosomia compared with the index pregnancy.
  
  
  METHODS
  The analysis was confined to women who required insulin in the subsequent pregnancy.
  
  
  RESULTS
  Among 369 women who were prospectively identified with a history of previous GDM, 95 required insulin - the study cohort. Insulin treatment was commenced at an earlier gestation in the subsequent pregnancy. The incidence of macrosomia was significantly less in the subsequent pregnancy in the group of women who required insulin in both pregnancies (p = 0.02).
  
  
  CONCLUSIONS
  This data suggests early treatment is of benefit to this high-risk group in the reduction of macrosomia.
authors.affiliation: UCD Obstetrics & Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Holles Street, Dublin 2, Ireland. mahernicola@hotmail.com
authors.forename: Nicola
authors.initials: N
authors.lastname: Maher
authors.forename: Fionnuala
authors.initials: F
authors.lastname: McAuliffe
authors.forename: Michael
authors.initials: M
authors.lastname: Foley
mesh_terms: D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D004035:Diet Therapy / Q000706:statistics & numerical data; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology / Q000517:prevention & control; D005951:Glucose Tolerance Test / Q000706:statistics & numerical data; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010298:Parity; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D018570:Risk Assessment; D013997:Time Factors
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin