Should we treat mild gestational diabetes? An Australian multicentre retrospective cohort study.

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Acta Diabetologica Pub Date : 2025-06-20 DOI:10.1007/s00592-025-02548-6

Victoria L Rudland, Emily Hibbert, Jeff Flack, Tang Wong, Vincent W Wong, Mark McLean, Dharmintra Pasupathy, David Simmons, N Wah Cheung

{"title":"Should we treat mild gestational diabetes? An Australian multicentre retrospective cohort study.","authors":"Victoria L Rudland, Emily Hibbert, Jeff Flack, Tang Wong, Vincent W Wong, Mark McLean, Dharmintra Pasupathy, David Simmons, N Wah Cheung","doi":"10.1007/s00592-025-02548-6","DOIUrl":null,"url":null,"abstract":"Aims: The International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria for gestational diabetes (GDM) were widely implemented in Australia, despite limited evidence of better pregnancy outcomes compared to the Australasian Diabetes in Pregnancy Society 1998 (ADIPS1998) criteria. We aimed to evaluate the effect of treatment on pregnancy outcomes for women with 'mild' GDM, defined as GDM diagnosed by one, but not both, sets of criteria.Methods: This multicentre, retrospective cohort study included 17,512 pregnant women in six neighbouring tertiary hospitals in Sydney, Australia, during 2016-2017, all of whom were screened for GDM using a three-point 75 g oral glucose tolerance test. Three hospitals diagnosed and treated GDM according to ADIPS1998 criteria, and three according to IADPSG criteria. For women with 'mild' GDM, we evaluated the effect of treatment versus no treatment on pregnancy outcomes. The primary outcome was large for gestational age. Secondary outcomes were small for gestational age, induction of labour, caesarean section, gestational hypertension, and preeclampsia.Results: 2320 (13.2%) pregnant women had 'mild' GDM. Treatment of women with IADPSG-only GDM (i.e. fasting glucose 5.1-5.4 mmol/L (91-97 mg/dL) and/or 1-hour glucose ≥ 10.0 mmol/L (≥ 180 mg/dL)) was associated with less large for gestational age infants than no treatment (RR 0.66, 95%CI 0.49-0.88, p = 0.004) but more induction of labour (RR 1.55, 95%CI 1.03-2.34, p = 0.032). Treatment of women with ADIPS1998-only GDM (i.e. 2-hour glucose 8.0-8.4 mmol/L (144-151 mg/dL)) did not significantly change pregnancy outcomes compared with no treatment.Conclusions: This study highlights the importance of treating even mild IADPSG-GDM to improve pregnancy outcomes.","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Diabetologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00592-025-02548-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Aims: The International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria for gestational diabetes (GDM) were widely implemented in Australia, despite limited evidence of better pregnancy outcomes compared to the Australasian Diabetes in Pregnancy Society 1998 (ADIPS1998) criteria. We aimed to evaluate the effect of treatment on pregnancy outcomes for women with 'mild' GDM, defined as GDM diagnosed by one, but not both, sets of criteria.

Methods: This multicentre, retrospective cohort study included 17,512 pregnant women in six neighbouring tertiary hospitals in Sydney, Australia, during 2016-2017, all of whom were screened for GDM using a three-point 75 g oral glucose tolerance test. Three hospitals diagnosed and treated GDM according to ADIPS1998 criteria, and three according to IADPSG criteria. For women with 'mild' GDM, we evaluated the effect of treatment versus no treatment on pregnancy outcomes. The primary outcome was large for gestational age. Secondary outcomes were small for gestational age, induction of labour, caesarean section, gestational hypertension, and preeclampsia.

Results: 2320 (13.2%) pregnant women had 'mild' GDM. Treatment of women with IADPSG-only GDM (i.e. fasting glucose 5.1-5.4 mmol/L (91-97 mg/dL) and/or 1-hour glucose ≥ 10.0 mmol/L (≥ 180 mg/dL)) was associated with less large for gestational age infants than no treatment (RR 0.66, 95%CI 0.49-0.88, p = 0.004) but more induction of labour (RR 1.55, 95%CI 1.03-2.34, p = 0.032). Treatment of women with ADIPS1998-only GDM (i.e. 2-hour glucose 8.0-8.4 mmol/L (144-151 mg/dL)) did not significantly change pregnancy outcomes compared with no treatment.

Conclusions: This study highlights the importance of treating even mild IADPSG-GDM to improve pregnancy outcomes.

查看原文本刊更多论文

我们应该治疗轻度妊娠糖尿病吗？一项澳大利亚多中心回顾性队列研究。

目的：国际妊娠糖尿病研究小组协会（IADPSG）对妊娠糖尿病（GDM）的诊断标准在澳大利亚得到了广泛实施，尽管与1998年澳大利亚妊娠糖尿病协会（ADIPS1998）标准相比，有有限的证据表明妊娠结局更好。我们旨在评估治疗对“轻度”GDM妇女妊娠结局的影响，“轻度”GDM定义为通过一组标准诊断的GDM，而不是两组标准。方法：这项多中心、回顾性队列研究纳入了2016-2017年澳大利亚悉尼6家邻近三级医院的17,512名孕妇，所有孕妇均采用75 g口服葡萄糖耐量三点试验筛查GDM。三家医院根据ADIPS1998标准诊断和治疗GDM，三家医院根据IADPSG标准诊断和治疗GDM。对于患有“轻度”GDM的女性，我们评估了治疗与未治疗对妊娠结局的影响。主要结果与胎龄有关。胎龄、引产、剖腹产、妊娠期高血压和先兆子痫的次要结局较小。结果：2320例（13.2%）孕妇患有“轻度”GDM。仅接受iadpsg治疗的女性GDM（即空腹血糖5.1-5.4 mmol/L （91-97 mg/dL）和/或1小时血糖≥10.0 mmol/L(≥180 mg/dL)）与未接受治疗的胎龄婴儿相比，体重更小（RR 0.66, 95%CI 0.49-0.88, p = 0.004），但更多的引产（RR 1.55, 95%CI 1.03-2.34, p = 0.032）。与未治疗相比，治疗仅患有adips1998的GDM的妇女（即2小时血糖8.0-8.4 mmol/L (144-151 mg/dL)）没有显著改变妊娠结局。结论：本研究强调了治疗轻度IADPSG-GDM对改善妊娠结局的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Acta Diabetologica 医学-内分泌学与代谢

CiteScore

7.30

自引率

2.60%

发文量

180

审稿时长

2 months

期刊介绍： Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.