Gestational diabetes & diabetes in pregnancy
Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy
Primary result · Composite adverse neonatal outcomeResult — go to the resultAdjusted risk difference −5.6 percentage points 95% CI −10.1 to −1.2Authors' conclusion
Immediate treatment of gestational diabetes before 20 weeks' gestation led to a modestly lower incidence of a composite of adverse neonatal outcomes than no immediate treatment; no material differences were observed for pregnancy-related hypertension or neonatal lean body mass.
Study context
- Population
- Women between 4 weeks' and 19 weeks 6 days' gestation with a risk factor for hyperglycemia and GDM (WHO 2013 criteria); initial OGTT at mean 15.6±2.5 weeks793 with follow-up data
- Participants
- 802 participants
- Comparison
- Immediate treatment of GDM vs deferred or no treatment
- Immediate treatmentn = 406
- Controln = 396reference
- Primary endpoint
- Three primary outcomes: composite of adverse neonatal outcomes (birth <37 weeks, birth trauma, birth weight ≥4500 g, respiratory distress, phototherapy, stillbirth or neonatal death, or shoulder dystocia); pregnancy-related hypertension (preeclampsia, eclampsia, or gestational hypertension); neonatal lean body mass
Methodological details1:1 randomisation
- 1:1 randomisation
Primary result
Composite adverse neonatal outcome
Adjusted risk difference
−5.6 percentage points
95% CI −10.1 to −1.2
Events by treatment group
Immediate treatmentvs Control
adjusted risk difference −5.6 percentage points (95% CI −10.1 to −1.2)
As reported in the abstract
Further findings
| Outcome | Immediate treatment | Control | Adjusted risk difference (percentage points) (95% CI) | |
|---|---|---|---|---|
| Pregnancy-related hypertension (primary outcome) | 10.6% | 9.9% | 0.7 (−1.6 to 2.9) | |
| −2024Difference, percentage points (linear scale) |
Mean, kg
| Outcome | Immediate treatment | Control | Adjusted mean difference (kg) (95% CI) | |
|---|---|---|---|---|
| Neonatal lean body mass (primary outcome) | 2.86 | 2.91 | −0.04 (−0.09 to 0.02) | |
| −0.1−0.0500.05Difference, kg (linear scale) |
- Pregnancy-related hypertension (primary outcome): Immediate treatment: 40 of 378; Control: 37 of 372
Safety
- No between-group differences in serious adverse events associated with screening and treatment
Original publication
Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy. N Engl J Med. Published 5 May 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →