Early Screening and Treatment of Women with Prediabetes: A Randomized Controlled Trial
- PMID: 26344009
- DOI: 10.1055/s-0035-1563715
Early Screening and Treatment of Women with Prediabetes: A Randomized Controlled Trial
Abstract
Objective: To examine whether women with prediabetes benefit from early treatment for gestational diabetes mellitus (GDM).
Study design: Women with a glycosylated hemoglobin A1C (A1C) of 5.7 to 6.4% at <14 weeks were recruited. Participants were randomized to usual care or treatment for GDM with diet, blood glucose monitoring, and insulin as needed. The primary outcome was a 75-g oral glucose tolerance test at 26 to 28 weeks. Secondary outcomes included cesarean delivery, birthweight, weight gain, and A1C change.
Results: Between May 2012 and June 2014, 95 women were enrolled and 83 had data for analysis; 42 were randomized to treatment and 41 to usual care. The groups were similar in baseline characteristics with 40% obese. There was no difference in the primary outcome (treatment 45.2% vs. control 56.1%; relative risk [RR] 0.80; 95% confidence interval [CI] 0.53-1.24) except that women in the treatment group had a significantly lower A1C over time than women in the control group (p = 0.04). Nonobese women (n = 50) treated for GDM experienced a 50% reduction in GDM compared with controls (29.6 vs. 60.9%; RR 0.49; 95% CI 0.25-0.95).
Conclusion: Early treatment for women with a first-trimester A1C of 5.7 to 6.4% did not significantly reduce the risk of GDM except in nonobese women.
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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