Should Glycemic Targets for Gestational Diabetes Be Changed?
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Use of tighter glycemic targets for women with gestational diabetes mellitus (GDM) reduced the risk for a serious health outcome for the infant, according to a trial conducted in New Zealand. These serious health outcomes included death, birth trauma, and shoulder dystocia. Infants' length of stay in the neonatal intensive care unit also was shorter. But the new targets did not reduce the infant's risk of being large for its gestational age. For the women, there was an increase in the risk for serious health outcomes, including postpartum hemorrhage, and an increased use of pharmacologic therapy to treat their hyperglycemia. These findings were reported in a recent article in PLOS Medicine.
@abhishikta As mentioned in the PLOS Medicine report, the TARGET trial was conducted at 10 maternity hospitals in New Zealand between May 2015 and November 2017. A total of 1100 women diagnosed with GDM at 22 to 34 weeks' gestation were enrolled, along with their 1108 infants. Every 4 months, two hospitals moved from using less stringent targets to tighter targets. Overall, 598 (55%) women (602 infants) were included while their hospital was allocated to the use of tighter targets, and 502 (45%) women (506 infants) were included while their hospital was allocated to the use of less stringent targets.