Study calls for early treatment of gestational diabetes
Treating gestational diabetes earlier in pregnancy gives mothers and babies more protection from possible complications, new research reveals.
Mothers already at high risk and treated before 20 weeks' gestation showed improved maternal and infant health and reduced complications, according to a study led by researchers at Western Sydney University.
Guidelines recommend intervening for treatment at between 24 and 28 weeks.
A total of 802 women from 17 hospitals in Australia, Austria, Sweden and India were studied in the trial with results published in the New England Journal of Medicine on Tuesday.
All women had a diabetes risk factor before 20 weeks' gestation and had gestational diabetes by the World Health Organisation definition.
Lead author Professor David Simmons from the Western Sydney University School of Medicine and Translational Health Research Institute said the study provided new evidence for those deemed at higher risk for early testing and treatment of gestational diabetes beyond the recommended approach.
Prof Simmons said his team felt treatment should be administered to mothers showing increased early glucose values but were still below those diagnostic of type 2 diabetes.
"We feel we should treat but data has been lacking to demonstrate the effects of such treatment on the mother or baby," he said.
"We have now filled this major knowledge gap likely affecting millions of pregnancies every year."
The study assessed pregnancy outcomes for mothers treated for gestational diabetes before 20 weeks compared to those given no early treatment.
Prof Simmons said early intervention correlated with avoiding severe birth complication and significantly reduced respiratory distress in babies.
"Over one in 20 babies avoided a group of severe birth complications including birth damage like broken bones or nerves, or getting stuck during birth known as shoulder dystocia," he said.
"In addition, breathing problems requiring oxygen were almost halved and the number of days needed in neonatal intensive care or special care unit were down by 40 per cent."
Severe damage to and around the mother's birth canal, known as perineal injury, was also reduced by more than 75 per cent.
The research team recommended further trials and long-term follow-up studies.
Prof Simmons said the findings indicate the existing guidelines for gestational diabetes should be reviewed.