Tight glucose control results in normal perinatal outcome in 150 patients with gestational diabetes.

Abstract

To determine whether tight control of blood glucose is associated with normal outcomes in gestational diabetes. We studied 150 consecutive patients with gestational diabetes referred to a diabetes in pregnancy clinic. Selection criteria were an abnormal glucose tolerance test, diabetic management by one physician, capillary blood glucose monitoring in the prenatal period, and delivery at Grace Hospital. Degree of glucose control during pregnancy and maternal and perinatal outcomes were determined by chart review. Overall average glucose levels were 4.9 mmol/L (89 mg/dL) before meals and 6.7 mmol/L (122 mg/dL) 1 hour after meals. Thirty-one percent of the patients were treated with insulin in the prenatal period. In this series, there was no perinatal mortality and no increased incidence of large or small for gestational age infants, cesarean delivery, preterm labor, pregnancy-induced hypertension, neonatal respiratory distress, hypoglycemia, polycythemia, symptomatic hyperbilirubinemia, symptomatic hypocalcemia, or congenital malformations. Tight glucose control is associated with normal perinatal outcome in gestational diabetes.