CONTEXT: Prevalence of gestational diabetes mellitus (GDM) and obesity continue to increase. OBJECTIVE: This study aimed to ascertain whether diet and exercise is a successful intervention for women with GDM and whether a subset of these women have comparable outcomes to those with normal glucose tolerance (NGT). DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study of five antenatal centers along the Irish Atlantic seaboard of 567 women diagnosed with GDM and 2499 women with NGT during pregnancy. INTERVENTION: Diet and exercise therapy on diagnosis of GDM were prescribed and multiple maternal and neonatal outcomes were examined. RESULTS: Infants of women with GDM were more likely to be hypoglycemic (adjusted odds ratio [aOR], 7.25; 95% confidence interval [CI], 2.94-17.9) at birth. They were more likely to be admitted to the neonatal intensive care unit (aOR, 2.16; 95% CI, 1.60-2.91). Macrosomia and large-for-gestational-age rates were lower in the GDM group (aOR, 0.48; 95% CI, 0.37-0.64 and aOR, 0.61; 95% CI, 0.46-0.82, respectively). There was no increase in small for gestational age among offspring of women with GDM (aOR, 0.81; 95% CI, 0.49-1.34). Women with diet-treated GDM and body mass index (BMI) < 25 kg/m(2) had similar outcomes to those with NGT of the same BMI group. Obesity increased risk for poor pregnancy outcomes regardless of diabetes status. CONCLUSION: Medical nutritional therapy and exercise for women with GDM may be successful in lowering rates of large for gestational age and macrosomia without increasing small-for-gestational-age rates. Women with GDM and a BMI less than 25 kg/m(2) had outcomes similar to those with NGT suggesting that these women could potentially be treated in a less resource intensive setting.
CONTEXT: Prevalence of gestational diabetes mellitus (GDM) and obesity continue to increase. OBJECTIVE: This study aimed to ascertain whether diet and exercise is a successful intervention for women with GDM and whether a subset of these women have comparable outcomes to those with normal glucose tolerance (NGT). DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study of five antenatal centers along the Irish Atlantic seaboard of 567 women diagnosed with GDM and 2499 women with NGT during pregnancy. INTERVENTION: Diet and exercise therapy on diagnosis of GDM were prescribed and multiple maternal and neonatal outcomes were examined. RESULTS:Infants of women with GDM were more likely to be hypoglycemic (adjusted odds ratio [aOR], 7.25; 95% confidence interval [CI], 2.94-17.9) at birth. They were more likely to be admitted to the neonatal intensive care unit (aOR, 2.16; 95% CI, 1.60-2.91). Macrosomia and large-for-gestational-age rates were lower in the GDM group (aOR, 0.48; 95% CI, 0.37-0.64 and aOR, 0.61; 95% CI, 0.46-0.82, respectively). There was no increase in small for gestational age among offspring of women with GDM (aOR, 0.81; 95% CI, 0.49-1.34). Women with diet-treated GDM and body mass index (BMI) < 25 kg/m(2) had similar outcomes to those with NGT of the same BMI group. Obesity increased risk for poor pregnancy outcomes regardless of diabetes status. CONCLUSION: Medical nutritional therapy and exercise for women with GDM may be successful in lowering rates of large for gestational age and macrosomia without increasing small-for-gestational-age rates. Women with GDM and a BMI less than 25 kg/m(2) had outcomes similar to those with NGT suggesting that these women could potentially be treated in a less resource intensive setting.
Authors: Karen L Lindsay; Lorraine Brennan; Maria A Kennelly; Sinéad Curran; Mary Coffey; Thomas P Smith; Michael E Foley; Mensud Hatunic; Fionnuala M McAuliffe Journal: Ir J Med Sci Date: 2018-01-20 Impact factor: 1.568
Authors: Lise L Kurtzhals; Sidse K Nørgaard; Anna L Secher; Vibeke L Nichum; Helle Ronneby; Ann Tabor; H David McIntyre; Peter Damm; Elisabeth Reinhardt Mathiesen Journal: Diabetologia Date: 2018-09-25 Impact factor: 10.122
Authors: Carla Assaf-Balut; Cristina Familiar; Nuria García de la Torre; Miguel A Rubio; Elena Bordiú; Laura Del Valle; Miriam Lara; Teresa Ruiz; Ana Ortolá; Irene Crespo; Alejandra Duran; Miguel A Herraiz; Nuria Izquierdo; Noelia Perez; Maria J Torrejon; Isabelle Runkle; Carmen Montañez; Alfonso L Calle-Pascual Journal: BMJ Open Diabetes Res Care Date: 2016-12-20
Authors: Carla Assaf-Balut; Nuria Garcia de la Torre; Alejandra Durán; Manuel Fuentes; Elena Bordiú; Laura Del Valle; Johanna Valerio; Cristina Familiar; Inés Jiménez; Miguel Angel Herraiz; Nuria Izquierdo; Maria José Torrejón; Isabelle Runkle; Maria Paz de Miguel; Inmaculada Moraga; Maria Carmen Montañez; Ana Barabash; Martín Cuesta; Miguel A Rubio; Alfonso Luis Calle-Pascual Journal: BMJ Open Diabetes Res Care Date: 2018-10-11