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Can a Diagnosis of Gestational Diabetes Be an Advantage to the Outcome of Pregnancy?

Diabetes Education Centre, Wollongong, Australia; 4/393 Crown Street, Wollongong, NSW, 2500, Australia

R. D. Griffiths, MSc,Hons

Diabetes Education Centre, Wollongong, Australia

Objectives: We examined the obstetric outcomes of 138 treated women with gestational diabetes mellitus (GDM) compared with 144 women who had a 2-hour, 75-g glucose tolerance test result of between 7.0 and 7.9 mmol/L (126 and 142 mg/dL, respectively).

Methods: The subjects for this study were consecutive patients from a universal testing program for GDM during 1993. Gestational diabetes mellitus was diagnosed if the 2-hour plasma glucose level was 8.0 mmol/L (144 mg/dL) or greater after a 75-g glucose load in the fasting state.

Results: Treated women with GDM had a macrosomia rate of 8.0%, which was significantly less (P < .02) than the rate of 17.4% in the "normal" women. Treated women with GDM had a 2.2% rate of fetuses weighing less than 2500 g, which was significantly lower (P = .05) than the 6.9% rte for normal women. Overall, insulin therapy was used in 23.2% of the women with GDM, and no insulin-treated woman had either a macrosomic fetus or a fetus weighing less than 2500 g.

Conclusions: Treated women with GDM, particularly those who receive insulin, have a more favorable fetal outcome than women who have a glucose result between 7.0 and 7.9 mmol/L (126 and 142 mg/dL). These results suggest that the current diagnostic criteria for GDM, with respect to fetal outcomes, may need revision, and an additional subgroup of pregnant women may benefit from dietary advice.

Key Words: Gestational diabetes • diabetes • pregnancy

Journal of the Society for Gynecologic Investigation, Vol. 2, No. 3, 523-525 (1995)
DOI: 10.1177/107155769500200303


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