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Insulin therapy for gestational diabetes.

D R Coustan, S B Lewis

    Obstetrics and Gynecology
    |March 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Treating gestational diabetes with insulin and diet significantly reduces the risk of delivering large babies. This intervention is more effective than diet alone or no treatment in preventing fetal macrosomia.

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    Area of Science:

    • Obstetrics and Gynecology
    • Endocrinology
    • Perinatology

    Background:

    • Gestational diabetes mellitus (GDM) is a common pregnancy complication.
    • Maternal hyperglycemia in GDM is associated with increased fetal growth and macrosomia.
    • Fetal macrosomia poses risks during delivery and for the infant's long-term health.

    Purpose of the Study:

    • To evaluate the efficacy of insulin therapy combined with a diabetic diet in preventing fetal macrosomia in patients with gestational diabetes.
    • To compare the outcomes of insulin and diet therapy versus diet alone or no intervention.

    Main Methods:

    • A randomized controlled trial involving 72 patients diagnosed with gestational diabetes.
    • Participants were assigned to three groups: insulin (20 units NPH, 10 units regular) plus diabetic diet, diet alone, or neither.

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  • Infant birth weight was the primary outcome measure.

    • Main Results:

    • The group receiving insulin and diet had the lowest incidence of macrosomia (7%, 2 out of 27 infants > 8.5 lbs).
    • The diet-alone group showed a 36.4% incidence of macrosomia (4 out of 11 infants > 8.5 lbs).
    • The untreated group had the highest incidence of macrosomia at 50% (17 out of 34 infants > 8.5 lbs).

    Conclusions:

    • Insulin therapy in conjunction with a diabetic diet is highly effective in reducing fetal macrosomia in gestational diabetes.
    • These findings support the use of insulin as a primary treatment modality for GDM to improve perinatal outcomes.
    • Early and effective management of gestational diabetes is crucial for preventing complications like macrosomia.