Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Women with gestational diabetes mellitus in the ACHOIS trial: risk factors . The Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) showed that treatment of pregnant women with mild gestational. diabetes mellitus – evaluation from the ACHOIS randomised trial Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial.

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Ultrasonography was performed in all subjects before the oral glucose-tolerance test to confirm the gestational age. Comment in N Engl J Med. Randomization in clinical trials: However, more infants of women in the intervention group were admitted to the neonatal nursery 71 percent vs. This randomized trial showed that although treatment of mild gestational diabetes mellitus did not reduce the frequency of the composite primary perinatal outcome, it did lower the risks of fetal overgrowth, shoulder dystocia, cesarean delivery, and preeclampsia.

A Multicenter, Randomized Trial of Treatment for Mild Gestational Diabetes

Author information Copyright and License information Disclaimer. A randomized controlled trial of stick glycemic control and tertiary level obstetric care versus routine obstetric care in the management of gestational diabetes: Table 2 Primary Perinatal Outcome.

Author manuscript; available in PMC Jan Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. Intravenous glucose treatment — no.

A Multicenter, Randomized Trial of Treatment for Mild Gestational Diabetes

In contrast, the frequency of small-for-gestational age infants and the frequency of admission to the neonatal intensive care unit did not differ significantly between the groups Table 3. Preventive Services Task Force. Nonstress testing, biophysical profile testing, and ultrasonography to assess fetal growth were not performed routinely in the treatment group but were reserved for standard obstetrical indications. Screening for gestational diabetes mellitus: The records of all enrolled women and their infants were reviewed at the time of their discharge from the hospital, and information regarding antepartum, intrapartum, and post-delivery complications was recorded.


Both the body-mass index at delivery and weight gain from enrollment to delivery were lower among women in the treatment group than among those in the control group Table 4.

Screening for gestational diabetes: There were no significant differences in demographic variables or results of the oral glucose-tolerance test between the women in the treatment group and those in the control group.

Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. From October through mid-Novemberwe identified 19, women who had an abnormal result on a glucose loading test, of whom 10, met the inclusion criteria; consented to undergo a blinded 3-hour oral glucose-tolerance test and to consider enrollment in the randomized trial.

The individual rates of neonatal hypoglycemia, hyperbilirubinemia, birth trauma, and elevated cord-blood C-peptide level did not differ significantly between the two groups.

The study was approved afhois the human subjects committee at each participating center. Composite end point — no. The extent to which a reduction in fetal size and in the frequency of large-for-gestational-age infants as a result of treatment may have contributed to the lower rate of cesarean deliveries is unknown. Women were invited to participate in this study if, between 24 weeks 0 days and 30 weeks 6 days of gestation, they had a blood glucose concentration between and mg per deciliter between 7.


Blackwell; Northwestern University — P. There were no perinatal deaths. Labor induction and cesarean delivery may be less commonly performed in academic medical centers, including the centers that participated in this study. Gestational hypertension was defined as a systolic pressure of mm Hg or more or a diastolic pressure of 90 mm Hg or more on two occasions at least 4 hours apart, or one elevated blood-pressure value subsequently treated with medication. A total of of these women were enrolled; women with mild gestational tsudy mellitus were assigned to the study treatment, and women with mild gestational diabetes mellitus were assigned to receive usual prenatal care.

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Effect of treatment of gestational diabetes mellitus on pregnancy outcomes.

It is uncertain whether treatment of mild gestational diabetes mellitus improves pregnancy outcomes. Associations among macrosomia, shoulder dystocia, and the increased risk of brachial plexus injury in the offspring of women with diabetes are well documented.

Women were assigned to receive either formal nutritional counseling and achoia therapy, 12 along with insulin if required treatment group or usual prenatal care control group. Nutrition recommendations and interventions for diabetes: A total of 37 women in the treatment group required insulin therapy, as compared with 2 in the control group.

Intensified versus conventional management of gestational diabetes. Preventive Services Task Force again concluded that current evidence is insufficient to assess the balance between benefit and harm with respect to the screening and treatment of gestational diabetes mellitus.