Regression From Early GDM to Normal Glucose Tolerance and Adverse Pregnancy Outcomes in the Treatment of Booking Gestational Diabetes Mellitus Study

David Simmons¹, Jincy Immanuel¹, William M Hague², Helena Teede³, Christopher J Nolan^{4

5}, Michael J Peek⁵, Jeff R Flack⁶, Mark McLean⁷, Vincent W Wong⁸, Emily J Hibbert⁹, Alexandra Kautzky-Willer¹⁰, Jürgen Harreiter^{10

11}, Helena Backman¹², Emily Gianatti¹³, Arianne Sweeting¹⁴, Viswanathan Mohan¹⁵, N Wah Cheung¹⁶; TOBOGM Research Group

Collaborators, Affiliations

Affiliations

¹ School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.
² Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
³ Monash University, Melbourne, Victoria, Australia.
⁴ The Canberra Hospital, Canberra, Australian Capital Territory, Australia.
⁵ Australian National University, Canberra, Australian Capital Territory, Australia.
⁶ Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia.
⁷ Blacktown Hospital, Sydney, New South Wales, Australia.
⁸ Liverpool Hospital and University of New South Wales, Liverpool, New South Wales, Australia.
⁹ Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, and Nepean Hospital, Sydney, New South Wales, Australia.
¹⁰ Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
¹¹ Department of Medicine, Landesklinikum Scheibbs, Scheibbs, Austria.
¹² Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
¹³ Endocrinology and Diabetes, Fiona Stanley Fremantle Hospitals Group, Murdoch, Western Australia, Australia.
¹⁴ Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
¹⁵ Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India.
¹⁶ Westmead Hospital, Sydney, New South Wales, Australia.

PMID: 38551955
DOI: 10.2337/dc23-2215

Randomized Controlled Trial

Regression From Early GDM to Normal Glucose Tolerance and Adverse Pregnancy Outcomes in the Treatment of Booking Gestational Diabetes Mellitus Study

David Simmons et al. Diabetes Care. 2024.

. 2024 Dec 1;47(12):2079-2084.

doi: 10.2337/dc23-2215.

Authors

Affiliations

¹ School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia.
² Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
³ Monash University, Melbourne, Victoria, Australia.
⁴ The Canberra Hospital, Canberra, Australian Capital Territory, Australia.
⁵ Australian National University, Canberra, Australian Capital Territory, Australia.
⁶ Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia.
⁷ Blacktown Hospital, Sydney, New South Wales, Australia.
⁸ Liverpool Hospital and University of New South Wales, Liverpool, New South Wales, Australia.
⁹ Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, and Nepean Hospital, Sydney, New South Wales, Australia.
¹⁰ Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
¹¹ Department of Medicine, Landesklinikum Scheibbs, Scheibbs, Austria.
¹² Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
¹³ Endocrinology and Diabetes, Fiona Stanley Fremantle Hospitals Group, Murdoch, Western Australia, Australia.
¹⁴ Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
¹⁵ Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India.
¹⁶ Westmead Hospital, Sydney, New South Wales, Australia.

PMID: 38551955
DOI: 10.2337/dc23-2215

Abstract

Objective: To compare pregnancy outcomes among women with a normal oral glucose tolerance test (OGTT) before 20 weeks' gestation (early) and at 24-28 weeks' gestation (late) (no gestational diabetes mellitus, or No-GDM), those with early GDM randomized to observation with a subsequent normal OGTT (GDM-Regression), and those with GDM on both occasions (GDM-Maintained).

Research design and methods: Women at <20 weeks' gestation with GDM risk factors who were recruited for a randomized controlled early GDM treatment trial were included. Women with treated early GDM and late GDM (according to the World Health Organization's 2013 criteria) were excluded from this analysis. Logistic regression compared pregnancy outcomes.

Results: GDM-Regression (n = 121) group risk factor profiles and OGTT results generally fell between the No-GDM (n = 2,218) and GDM-Maintained (n = 254) groups, with adjusted incidences of pregnancy complications similar between the GDM-Regression and No-GDM groups.

Conclusions: Women with early GDM but normal OGTT at 24-28 weeks' gestation had pregnancy outcomes that were similar to those of individuals without GDM. Identifying early GDM likely to regress would allow treatment to be avoided.

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Regression From Early GDM to Normal Glucose Tolerance and Adverse Pregnancy Outcomes in the Treatment of Booking Gestational Diabetes Mellitus Study

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Regression From Early GDM to Normal Glucose Tolerance and Adverse Pregnancy Outcomes in the Treatment of Booking Gestational Diabetes Mellitus Study

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