A randomised controlled pilot study of the management of gestational impaired glucose tolerance

Abstract

Objective: To determine whether a study of a less intensive form of management for impaired glucose tolerance in pregnancy is feasible and whether women would accept randomisation.

Design: Prospective randomised controlled study.

Setting: A large district general hospital and a large teaching hospital in West Yorkshire.

Sample: Seventy women with impaired glucose tolerance in pregnancy.

Methods: One group monitored plasma glucose up to four times daily. The other group did not monitor plasma glucose at all.

Main outcome measures: The number of women recruited of those approached and neonatal admissions to special care baby units in each group.

Results: Sixty-eight of 70 women approached entered the study. There were no statistically significant differences between the groups in neonatal outcome measures. The median number of plasma glucose measurements in the monitored group was 118 (range 0-500), and 19% of women in the monitored group were treated with insulin.

Conclusions: This study fails to demonstrate any benefit from intensive management of impaired glucose tolerance in pregnancy with additional maternal inconvenience. This pilot study has shown that a large randomised controlled study of the management of impaired glucose tolerance in pregnancy is not only feasible but necessary.