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Randomized controlled study in pregnancy on treatment of marked hyperglycemia that is short of overt diabetes
Örebro universitet, Institutionen för hälsovetenskap och medicin.ORCID-id: 0000-0002-2691-7525
Department of Obstetrics and Gynecology, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
UltraGyn Clinic, Stockholm, Sweden.
Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden.
Vise andre og tillknytning
2015 (engelsk)Inngår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 94, nr 11, s. 1181-1187Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Introduction: A randomized multicenter study was conducted in the Stockholm-orebro areas in Sweden to evaluate how treatment aiming at normoglycemia affects fetal growth, pregnancy and neonatal outcome in pregnant women with severe hyperglycemia.

Material and methods: Pregnant women with hyperglycemia defined as fasting capillary plasma glucose <7.0 mmol/L and a two-hour plasma glucose value 10.0 and <12.2 mmol/L following a 75-g oral glucose tolerance test (OGTT) diagnosed before 34 weeks of gestation were randomized to treatment (n=33) or controls (n=36). Women assigned to the control group were blinded for the OGTT results and received routine care. The therapeutic goal was fasting plasma glucose 4-5 mmol/L, and <6.5 mmol/L after a meal. Primary outcomes were size at birth and number of large-for-gestational age (>90th percentile) neonates. Secondary outcomes were pregnancy complications, neonatal morbidity and glycemic control.

Results: The planned number of participating women was not reached. There was a significantly reduced rate of large-for-gestational age neonates, 21 vs. 47%, P<0.05. Group differences in pregnancy complications and neonatal morbidity were not detected because of limited statistical power. In total, 66.7% of the women in the intervention group received insulin. Of all measured plasma glucose values, 64.1% were in the target range, 7.2% in the hypoglycemic range and 28.7% above target values. There were no cases of severe hypoglycemia.

Conclusions: Aiming for normalized glycemia in a pregnancy complicated by severe hyperglycemia reduces fetal growth but is associated with an increased rate of mild hypoglycemia.

sted, utgiver, år, opplag, sider
Wiley-Blackwell, 2015. Vol. 94, nr 11, s. 1181-1187
Emneord [en]
Pregnancy, gestational diabetes mellitus, hyperglycemia, treatment, birthweight, compliance, large-for-gestational age
HSV kategori
Forskningsprogram
Obstetrik och gynekologi
Identifikatorer
URN: urn:nbn:se:oru:diva-46438DOI: 10.1111/aogs.12717ISI: 000362844400006PubMedID: 26222270Scopus ID: 2-s2.0-84943587292OAI: oai:DiVA.org:oru-46438DiVA, id: diva2:868376
Forskningsfinansiär
Swedish Diabetes Association
Merknad

Funding Agencies:

Uppsala-Örebro Regional Research Council

Praktikertjänst AB, Stockholm, Sweden

Tilgjengelig fra: 2015-11-10 Laget: 2015-11-10 Sist oppdatert: 2018-04-16bibliografisk kontrollert

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Fadl, Helena E.Åman, JanÖstlund, Ingrid K.Hanson, Ulf S. B.

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