Different intensities of glycaemic control for pregnant women with pre-existing diabetes.

Abstract:

BACKGROUND:The optimal glycaemic control target in pregnant women with pre-existing diabetes is unclear, although there is a clear link between high glucose concentrations and adverse birth outcomes. OBJECTIVES:To assess the effects of different intensities of glycaemic control in pregnant women with pre-existing type 1 or type 2 diabetes. SEARCH STRATEGY:We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (7 May 2010). SELECTION CRITERIA:We included randomised controlled trials comparing different glycaemic control targets in pregnant women with pre-existing diabetes. DATA COLLECTION AND ANALYSIS:Two review authors assessed trial eligibility and risk of bias, and extracted data. MAIN RESULTS:We included three trials all in women with type 1 diabetes (223 women and babies), and all with a high risk of bias. Two trials compared very tight (3.33 to 5.0 mmol/L fasting blood glucose (FBG)) with tight-moderate (4.45 to 6.38) glycaemic control targets, with one trial of 22 babies reporting no perinatal deaths or serious perinatal morbidity. In the same trial, there were two birth defects in the very tight and none in the tight-moderate group with no significant differences in caesarean section between groups (risk ratio 0.92, 95% confidence interval (CI) 0.49 to 1.73). In these two trials glycaemic control was not significantly different between the very tight and tight-moderate groups by the third trimester, although one trial of 22 women found significantly less maternal hypoglycaemia in the tight-moderate group.In a trial of 60 women and babies comparing tight (

authors

Middleton P,Crowther CA,Simmonds L,Muller P

doi

10.1002/14651858.CD008540.pub2

subject

Has Abstract

pub_date

2010-09-08 00:00:00

pages

CD008540

issue

9

issn

1469-493X

pub_type

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