Weight loss in gestational diabetes improves pregnancy outcomes, study finds
Australia: A recent study has pointed out that weight loss even after the diagnosis of gestational diabetes confers additional benefits to glucose-lowering treatment. This results in lower doses of mean insulin, and lower rates of large for gestational age infants without escalating the risk of small for gestational age infants. The findings of the study appear in the journal Diabetic Medicine.
Staying active and eating a low glycemic diet help is key to managing weight in gestational diabetes, and it also helps in controlling blood sugar levels. Robyn A. Barnes, The University of Newcastle University Drive, Callaghan, Australia, and colleagues assessed the impact of achieving a personalized weight target based on the Institute of Medicine in addition to conventional glycaemic management after gestational diabetes mellitus diagnosis on maternal and neonatal outcomes.
For achieving their objective, Barnes and the team conducted a retrospective audit of clinical data (2016 to 2019) for singleton gestational diabetes pregnancies in a multi-ethnic cohort. Relationships between achieving, exceeding, and gaining less than a personalized weight target provided after gestational diabetes diagnosis and rates of large for gestational age, small for gestational age infants, insulin therapy initiation, and neonatal outcomes were assessed. Adjusted odds ratios (aOR) were adjusted for glucose 2-hour post glucose load value, family history of type 2 diabetes, previous gestational diabetes, macrosomia in a previous pregnancy, and East and South-East Asian ethnicity.
Based on the study, the researchers found the following:
- Of 1034 women, 44% (n=449) achieved their personalized weight target.
- Women who exceeded their personalized weight target had significantly and higher mean insulin doses (28.8 ± 21.5 units vs 22.7 ± 18.7) and higher rates of large for gestational age infants (19% vs 9.8%), with an adjusted odds ratio (aOR) of 1.99, but no difference in rates of small for gestational age infants (5.3% versus 8.0%) (aOR 0.77).
- Lower rates of large for gestational age infants occurred in those who gained below their personalized weight target (aOR 0.48), but rates of small for gestational age infants concurrently increased (aOR 1.9).
The authors concluded, "weight management after gestational diabetes diagnosis does not appear to be too late to confer additional benefits to glucose-lowering treatment, resulting in lower mean insulin doses, and lower rates of large for gestational age infants without increasing the risk of small for gestational age infants."
Reference:
The study titled, "Does weight management after Gestational Diabetes Mellitus diagnosis improve pregnancy outcomes? A multi-ethnic cohort study," is published in the journal Diabetic Medicine.
DOI: https://onlinelibrary.wiley.com/doi/10.1111/dme.14692
