Pregnancy

Researchers highlight need for universal thresholds for treating gestational diabetes

by Barbara Hewitt on September 16, 2016

There is an urgent need to find the best threshold to balance the potential benefits and harms of diabetes treatment for pregnant women, according to the authors of new research.

The team from the Universities of York and Bristol in the UK and the NHS Bradford Institute for Health Research said it has found a consistent association between higher blood glucose (sugar) levels during pregnancy and increased risk of complications around the time of birth.

pregnancyBut currently in the UK there is no clear threshold of when to intervene with treatment. Researchers believe that there is now an urgent need to work out the best threshold to balance the benefits and harms of treating women with high blood glucose levels during pregnancy.

Gestational diabetes is associated with increased risk of a range of adverse outcomes around the time of birth and can affect the longer term health of mother and infant. Although treatment can reduce the risk of these outcomes, the optimal glucose threshold to define gestational diabetes is unknown.

A team of researchers, based across the UK and Ireland, set out to examine the association between blood glucose levels in pregnant women without pre-existing diabetes and birth outcomes, such as whether they needed a caesarean section.

Looking at 23 studies involving over 200,000 women and their infants, mainly from high income countries across Asia, Australasia, Europe and North America, they explored the association between pregnancy blood glucose and outcomes for the mother and her baby.

When combining results there was a straight line association between glucose levels and caesarean section, induction of labour, a heavy baby, and shoulder dystocia, the baby getting stuck as their mother gives birth.

This means that, for each blood glucose increase, the risk of these problems increased by a similar amount, but there was no clear evidence of a threshold effect and this straight line pattern was similar when the team looked at studies separately to explore the impact of study quality, type of glucose exposure and different geographical regions. These results showed that there is no obvious level to diagnose gestational diabetes.

‘These important results show the challenges of screening for conditions like diabetes and hypertension and deciding how to act on the results of tests,’ said Professor Trevor Sheldon, Dean of the Hull York Medical School.

‘If the threshold is set low, too many women will be labelled as being at raised risk of having a baby who has problems at birth. On the other hand if the threshold is too high we will miss women who would have benefitted from treatment. Ultimately this comes down to balancing risks, costs and benefits. Health economists in the team are working on this and are due to report shortly,’ he added.

{ 0 comments }

Thumbnail image for New research aims to understand more about gestational diabetes

New research aims to understand more about gestational diabetes

June 28, 2016 Diabetes General

With the number of women developing diabetes during pregnancy increasing, new research aims to find out more about its effect on mothers and their babies. Gestational diabetes rates are considered to be climbing due to more women being obese and their babies tend to be much bigger and more prone to problems at birth so […]

Read the full article →
Thumbnail image for Early research suggests breastfeeding helps combat diabetes risk for mums and babies

Early research suggests breastfeeding helps combat diabetes risk for mums and babies

December 9, 2015 News

Early stage research suggests that breastfeeding could affect a woman’s risk of getting type 2 diabetes and reduce the baby’s risk too. Researchers in Canada believe breastfeeding uses up excess fat and sugar in a mother’s body, helping protect her from diabetes. As well, babies given breast milk are far less likely to become obese, […]

Read the full article →
Thumbnail image for Study suggests abdominal fat could be used to detect diabetes risk in pregnant women

Study suggests abdominal fat could be used to detect diabetes risk in pregnant women

November 6, 2015 Pregnancy

Women who have high levels of abdominal fat during their first trimester of pregnancy have a higher risk of developing diabetes later in their pregnancy, a new study has found. It means that doctors should consider screening women earlier in pregnancy with the amount of tummy fat being used as an indicator, according to the […]

Read the full article →
Thumbnail image for New test developed for new mums at risk of diabetes

New test developed for new mums at risk of diabetes

October 28, 2015 Diabetes Research Polls

Researchers in Germany have developed a new simple test for predicting the risk of developing type 2 diabetes following childbirth. Gestational diabetes is one of the most common conditions that can occur during pregnancy and women who suffer from the condition have a higher risk of developing it afterwards as well. Now researchers at the […]

Read the full article →
Thumbnail image for South Asian predisposition to type 2 diabetes could start at birth

South Asian predisposition to type 2 diabetes could start at birth

October 6, 2015 Pregnancy

New research suggests that the risks of developing type 2 diabetes for people of South Asian origin begins immediately at birth. South Asians are known as an ethnic grouping that can suffer from substantially higher rates of diabetes but scientists believe that prevention during pregnancy could help reduce this. They suggest that South Asian women […]

Read the full article →
Thumbnail image for Risk warning for children whose mothers had gestational diabetes

Risk warning for children whose mothers had gestational diabetes

September 4, 2015 Diabetes General

Children are six times more likely to develop type 2 diabetes in later life if their mother had gestational diabetes and risk health problems as a result, it is suggested. Leading charity Diabetes UK is urging women to try to make sure they are a healthy weight, which is the most important thing they can […]

Read the full article →
Thumbnail image for Gestational diabetes affects future risk of type 2 for dads

Gestational diabetes affects future risk of type 2 for dads

August 18, 2015 Diabetes General

Gestational diabetes, which affects up to 20% of pregnant women, can increase the risk of a woman getting type 2 diabetes in later life, but now research suggests it can affect fathers as well. It is well known that women with gestational diabetes are seven times as likely to eventually develop type 2 diabetes but […]

Read the full article →
Thumbnail image for Alcohol consumed around time of conception has diabetes risk for offspring

Alcohol consumed around time of conception has diabetes risk for offspring

July 31, 2015 Pregnancy

Babies conceived by women who drink alcohol around the time of conception face dramatically increased risks of type 2 diabetes and obesity in early middle age, new research has found. Scientists from the School of Biomedical Sciences at the University of Queensland in Australia made the discovery while looking at how certain events, particularly alcohol […]

Read the full article →
Thumbnail image for Lifestyle change does not prevent gestational diabetes, study finds

Lifestyle change does not prevent gestational diabetes, study finds

July 14, 2015 Pregnancy

A diet and exercise regime for high-risk obese pregnant women is effective in promoting a healthy lifestyle but it does not prevent gestational diabetes, new research has found. According to the study led by King’s College London, programmes promoting healthy behaviour are unlikely to be effective in preventing gestational diabetes in obese women. They suggest […]

Read the full article →
Thumbnail image for Scientists warn over lower diabetes threshold for pregnant women in UK

Scientists warn over lower diabetes threshold for pregnant women in UK

June 10, 2015 Pregnancy

A new threshold for diabetes in pregnancy recently introduced in the UK misses thousands of women at risk of serious complications and is less effective than those set by the World Health Organisation, according to scientists. A team of researchers from the University of Cambridge and Cambridge University Hospitals Foundation Trust found that the National […]

Read the full article →



The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.