| Author, Year, (Total N) Glycemic level of participants |
Random- ization |
GDM Diagnosis Inclusion |
Glycemic Separation During Study |
% Stillbirth (Stat Sig) |
Birth weight > 4,000 g (Stat Sig) |
% Large for Gesta- tional Age (Stat Sig) |
Neonatal Outcomes | % Total Cesarean Delivery (Stat Sig) |
||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| % Brachial Plexus Injury (Stat Sig) |
% Clavicular Fracture (Stat Sig) |
% Hypoglycemia (Stat Sig) |
% Hyperbili- rubinemia (Stat Sig) |
% Hypocalcemia (Stat Sig) |
||||||||
| Li et al., 198781 (N =158) Low |
A: Controls: No treatment (n = 73) B: Treatment; diet, monitoring (n = 85) |
GDM by NDDG65 criteria and normal or impaired glucose tolerance by WHO64 criteria | NR | NR | A: 7 B: 4 (NS) |
A: 22 B: 18 (NS) |
A: 0 B: 0 (NS) |
A: 0 B: 0 (NS) |
No difference | NR | NR | A: 26 B: 27 (NS) |
| Buchanan et al., 199483 (N = 59) Low |
A: Diet (n = 29) B: Diet and twice-daily insulin (n = 30) |
GDM and fasting blood glucose <105 mg/dL; fetal ultrasound AC >75th percentile | 5.4 - 10.8 mg/dL mean glucose difference in mixed-meal tolerance test |
NR | NR | A: 45 B: 13 (P <0.02) |
A: 0 B: 0 (NS) |
A: 0 B: 0 (NS) |
A: 18 B: 14 (NS) (lab diagnosis) |
NR | NR | A: 14-21 B: 43 (P <0.05) |
| Garner et al., 199720 (N = 300) Low |
A: Routine care (n = 150) B: Strict glycemic control and tertiary care (n = 149) |
Hatem and Dennis, 1987104 criteria. Controls treated with insulin if fasting blood glucose >140 mg/dL or 1-hr postprandial value >200 mg/dL (n = 16) |
Lower in treated group by 5 - 9 mg/dL 1 hr postprandial |
A: 0 B: 0 (NS) |
A: 18.7 B: 16.1 (NS) |
NR | A: 0 B: 0 (NS) |
A: 0 B: 0 (NS) |
A: 8.7 B: 14.1 (NS) |
A: 6.6 B: 5.4 (NS) |
A: 30 B: 40.9 (P = 0.048) |
A: 18.6 B: 20.1 (NS) |
| Bancroft et al., 200080
(N = 68) Low |
A: Diet and no diabetic monitoring (n = 36) B: Diet and intensive diabetic monitoring (n = 32) |
WHO64 criteria. Fasting blood glucose <126 mg/dL; 2-hr 75 g = 140-200 mg/dL |
HbA1c: 0.2% - 0.7% difference |
A: 0 B: 0 (NS) |
NR | A: 7 B: 8 (NS) |
NR | NR | NR | NR | NR | A; 31 B: 31 (NS) |
| Persson et al., 198560
(N = 202) High |
A: Diet, add insulin for high glucose (n = 105) B: Diet and insulin (n = 97) |
Impaired glucose tolerance | No difference | A: 0 B: 0 (NS) |
NR | A: 13 B: 11 (NS) |
NR | NR | A: 0 B: 5 (NS) |
A: 20 B: 20 (NS) |
A: 6.7 B: 12.5 (NS) |
NR |
| Langer et al., 198982
(N = 272) High |
A: Controls: No treatment (n = 146) B: Treatment: Diet and/or insulin (n = 126) |
NDDG65 criteria One abnormal value on 3-hr glucose tolerance test B: Goal of glucose <95 mg/dL |
24 mg/dL difference in mean capillary blood glucose | NR | NR | A: 26 B: 6 (P <0.05) |
NR | NR | A: 13 B: 2 (P <0.02) (lab diagnosis) |
A: 14 B: 6 (NS) (lab diagnosis) |
NR | A: 11 B: 10 (NS) |
| Nachum et al., 199958 (N = 274) High |
A: Diet and twice daily insulin (n=136) B: Diet and 4 times daily insulin (n=138) |
NDDG65 criteria | 3.4 mg/dL difference in mean blood glucose; 0.3% in HbA1c |
A: 0.7 B: 0 (NS) |
A: 19 B: 16 (NS) |
A: 30 B: 26 (NS) |
A: 2.2 B: 1.4 (NS) |
A: 0 B: 0 (NS) |
A: 5.9 B: 0.7 (P = 0.02) (lab diagnosis) |
A: 21 B: 11 (NS) |
A: 0 B: 0.7 (NS) (lab diagnosis) |
A; 28 B: 28 (NS) |
| Kjos et al., 200129 (N = 96) High |
A: Standard: Insulin (n = 48) B: Experimental Insulin only if fetal AC is = 70th percentile (n = 48) |
Fasting plasma glucose >105 and <120 mg/dL | Mean fasting plasma glucose: 88.1 (B) 84.9 (A) 3.2 mg/dL difference |
No difference (only one reported) |
A: 4.2 B: 6.3 (NS) |
A: 6.3 B: 8.3 (NS) |
No difference (small number) |
No difference (small number) |
A: 10.4 B: 10.4 (NS) |
A: 2 B: 4 (NS) |
NR | A: 14.6 B: 33.3 P = 0.03 (Greater % of women with previous cesarean delivery in Group B) |
| de Veciana et al., 199559
(N = 66) Insulin-Dependent GDM Very high |
A: Preprandial monitoring (n = 33) B: Postprandial monitoring (n = 33) |
NDDG65 criteria Fasting plasma glucose >105 mg/dL or 1-hr >140 mg/dL |
1.6% difference in HbA1c | A: 3 B: 0 (NS) |
A: 36 B: 9 (P = 0.01) |
A: 42 B: 12 (P = 0.01) |
A: 0 B: 0 (NS) |
A: 3 B: 3 (NS) |
A: 21 B: 3 (P = 0.05) |
A: 12 B: 9 (NS) |
NR | A: 39 (CPD: 3) B: 24 (CPD: 12) (P 0.04) |
Note: AC indicates abdominal circumference; CPD, cephalopelvic disproportion; GDM, gestational diabetes mellitus; NDDG, National Diabetes Data Group; NR, not reported; NS, not statistically significant; Stat Sig, statistical significance; WHO, World Health Organization.