The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study
Objective. In vivo study of glucose homeostasis in pregnancy suggests normal glucose levels are lower than current glycemic targets used in gestational diabetes. After the HAPO study results, our institution began using glycemic targets of fasting 85 mg/dL and 2-hour postprandial of 110 mg/dL. We re...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2019/6372474 |
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| _version_ | 1849473177530400768 |
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| author | Grace Hagen Crystal Brown Jordan Dietrich Charles Gibbs Gene T. Lee |
| author_facet | Grace Hagen Crystal Brown Jordan Dietrich Charles Gibbs Gene T. Lee |
| author_sort | Grace Hagen |
| collection | DOAJ |
| description | Objective. In vivo study of glucose homeostasis in pregnancy suggests normal glucose levels are lower than current glycemic targets used in gestational diabetes. After the HAPO study results, our institution began using glycemic targets of fasting 85 mg/dL and 2-hour postprandial of 110 mg/dL. We reviewed our results. Methods. A retrospective cohort of GDM patients that delivered at KUMC from January 2007 to May 2017 was reviewed. All patients were diagnosed with the 2-step Carpenter-Coustan thresholds. High targets were compared with low targets. The primary outcome investigated was birthweight>90% (large for gestational age, LGA). Results. 604 patients were studied, and 34% were treated with low glycemic targets. Our unadjusted results showed that the low-target group had a lower incidence of LGA infants (24.0 vs. 31.8%), higher incidence of neonatal hypoglycemia (20.7 vs. 11.6%), and inductions (39.4 vs. 20.5%). After adjustment for demographic variables, only a higher risk of inductions remained (aOR 2.54 (1.44, 4.49)). Conclusion. Lower glycemic targets did not produce large reductions in fetal overgrowth, but they were associated with a higher rate of inductions. As there were no observed differences in maternal or neonatal outcomes otherwise, aiming for lower glycemic targets in GDM is likely not cost-effective. |
| format | Article |
| id | doaj-art-d91a9db58a2449c58aa055de89d99fa1 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-d91a9db58a2449c58aa055de89d99fa12025-08-20T03:24:15ZengWileyJournal of Diabetes Research2314-67452314-67532019-01-01201910.1155/2019/63724746372474The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective StudyGrace Hagen0Crystal Brown1Jordan Dietrich2Charles Gibbs3Gene T. Lee4Department of OBGYN, University of Kansas Medical Center, Kansas City, KS, USADepartment of OBGYN, University of Kansas Medical Center, Kansas City, KS, USADepartment of OBGYN, University of Kansas Medical Center, Kansas City, KS, USADepartment of OBGYN, University of Kansas Medical Center, Kansas City, KS, USADepartment of OBGYN, University of Kansas Medical Center, Kansas City, KS, USAObjective. In vivo study of glucose homeostasis in pregnancy suggests normal glucose levels are lower than current glycemic targets used in gestational diabetes. After the HAPO study results, our institution began using glycemic targets of fasting 85 mg/dL and 2-hour postprandial of 110 mg/dL. We reviewed our results. Methods. A retrospective cohort of GDM patients that delivered at KUMC from January 2007 to May 2017 was reviewed. All patients were diagnosed with the 2-step Carpenter-Coustan thresholds. High targets were compared with low targets. The primary outcome investigated was birthweight>90% (large for gestational age, LGA). Results. 604 patients were studied, and 34% were treated with low glycemic targets. Our unadjusted results showed that the low-target group had a lower incidence of LGA infants (24.0 vs. 31.8%), higher incidence of neonatal hypoglycemia (20.7 vs. 11.6%), and inductions (39.4 vs. 20.5%). After adjustment for demographic variables, only a higher risk of inductions remained (aOR 2.54 (1.44, 4.49)). Conclusion. Lower glycemic targets did not produce large reductions in fetal overgrowth, but they were associated with a higher rate of inductions. As there were no observed differences in maternal or neonatal outcomes otherwise, aiming for lower glycemic targets in GDM is likely not cost-effective.http://dx.doi.org/10.1155/2019/6372474 |
| spellingShingle | Grace Hagen Crystal Brown Jordan Dietrich Charles Gibbs Gene T. Lee The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study Journal of Diabetes Research |
| title | The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study |
| title_full | The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study |
| title_fullStr | The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study |
| title_full_unstemmed | The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study |
| title_short | The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study |
| title_sort | utility of lower glycemic targets for treating gestational diabetes a retrospective study |
| url | http://dx.doi.org/10.1155/2019/6372474 |
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