Very tight vs. tight control: what should be the criteria for pharmacologic therapy dose adjustment in diabetes in pregnancy? Evidence from randomized controlled trials

Very tight vs. tight control: what should be the criteria for pharmacologic therapy dose... AbbreviationsDMdiabetes mellitusGMDgestational diabetes mellitusNPHneutral protamine HagedornRCTrandomized controlled trialKey messageThe majority of trials used very tight criteria of either one or two values per week higher than the target values for pharmacologic diabetes therapy dose adjustment.IntroductionCarbohydrate disorders in pregnancy, including gestational diabetes mellitus (GMD) and pregestational diabetes mellitus (DM), are the most common morbidities complicating pregnancy, with short‐ and long‐term consequences to mothers, fetuses, and newborns. It has been estimated that up to 6–7% or more of all pregnancies are complicated by DM in pregnancy . The latest reports from the International Diabetes Federation estimate that, worldwide, approximately one in seven births in 2015 were complicated by some form of hyperglycemia during pregnancy .Management for women with carbohydrate disorders in pregnancy includes diet, physical activity, oral hypoglycemic agents or insulin as needed. The management of those women aims to achieve the best possible glycemic control, with normal or near normal glucose values while avoiding hypoglycemia. This management is effective in reducing maternal and neonatal morbidity and mortality .Nevertheless, the optimal schedule, frequency and timing of glucose monitoring remains disputable, as are the glycemic metabolic goals. Moreover, there is no evidence from randomized controlled trials (RCTs) to support any specific criteria for http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acta Obstetricia Et Gynecologica Scandinavica Wiley

Very tight vs. tight control: what should be the criteria for pharmacologic therapy dose adjustment in diabetes in pregnancy? Evidence from randomized controlled trials

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Publisher
Wiley
Copyright
Copyright © 2018 Acta Obstetricia et Gynecologica Scandinavica
ISSN
0001-6349
eISSN
1600-0412
D.O.I.
10.1111/aogs.13257
Publisher site
See Article on Publisher Site

Abstract

AbbreviationsDMdiabetes mellitusGMDgestational diabetes mellitusNPHneutral protamine HagedornRCTrandomized controlled trialKey messageThe majority of trials used very tight criteria of either one or two values per week higher than the target values for pharmacologic diabetes therapy dose adjustment.IntroductionCarbohydrate disorders in pregnancy, including gestational diabetes mellitus (GMD) and pregestational diabetes mellitus (DM), are the most common morbidities complicating pregnancy, with short‐ and long‐term consequences to mothers, fetuses, and newborns. It has been estimated that up to 6–7% or more of all pregnancies are complicated by DM in pregnancy . The latest reports from the International Diabetes Federation estimate that, worldwide, approximately one in seven births in 2015 were complicated by some form of hyperglycemia during pregnancy .Management for women with carbohydrate disorders in pregnancy includes diet, physical activity, oral hypoglycemic agents or insulin as needed. The management of those women aims to achieve the best possible glycemic control, with normal or near normal glucose values while avoiding hypoglycemia. This management is effective in reducing maternal and neonatal morbidity and mortality .Nevertheless, the optimal schedule, frequency and timing of glucose monitoring remains disputable, as are the glycemic metabolic goals. Moreover, there is no evidence from randomized controlled trials (RCTs) to support any specific criteria for

Journal

Acta Obstetricia Et Gynecologica ScandinavicaWiley

Published: Jan 1, 2018

Keywords: ; ; ; ; ;

References

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