In:
Diabetic Medicine, Wiley, Vol. 36, No. 2 ( 2019-02), p. 177-183
Abstract:
Optimal glycaemic targets for gestational diabetes mellitus (GDM) are controversial because there are no randomized trials comparing targets and pregnancy outcomes. In this large observational study of two healthcare networks, the service with tight targets had greater insulin use and obstetric interventions than the service with standard targets. Tight targets were associated with no difference in primary birthweight or maternal outcomes, with decreased hypoglycaemia, jaundice and respiratory distress, but lower Apgar scores. Whether mixed observations relate to targets or obstetric practice variation is unclear. Clinical variation in obstetric practice was significant and insulin use alone was not a good marker of neonatal risk. Interventional studies are needed to define glycaemic targets for optimizing pregnancy outcomes.
Type of Medium:
Online Resource
ISSN:
0742-3071
,
1464-5491
DOI:
10.1111/dme.2019.36.issue-2
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
2019647-7