Blood Sugar Levels Predict Complications

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Blood Sugar Levels Predict Complications
Even pregnant women with high 'normal' levels face risks

Blood Sugar Levels Predict Complications (HealthDay News) -- The higher a woman's blood sugar levels go during a glucose tolerance test, the more likely she is to experience pregnancy complications, researchers now believe.

And that's true even if the blood sugar levels aren't high enough to classify the woman as having diabetes, according to a study from the New England Journal of Medicine .

"We found strong independent associations between a mother's blood sugar levels during an oral glucose tolerance test and 28 weeks of gestation and the pregnancy outcomes," the study's lead author, Dr. Boyd Metzger, a professor of metabolism and nutrition at the Feinberg School of Medicine at Northwestern University in Chicago, told HealthDay .

Early in pregnancy, high blood sugar can lead to birth defects or miscarriage, according to the U.S. Centers for Disease Control and Prevention. Later in pregnancy, out-of-control blood sugar levels can cause a baby to be stillborn, born premature, born at a low birth weight or, conversely, born extra large, which causes a difficult delivery.

The study was done at 15 centers in more than nine countries and included more than 23,000 pregnant women. At the beginning of the study, none of the women had been diagnosed with diabetes.

At some point between 24 and 32 weeks into their pregnancies, the mothers underwent glucose tolerance testing. People having the test must first fast so that a baseline blood sugar level can be obtained. Test-takers then drink a sugary, high-carbohydrate drink and have their blood sugar levels checked periodically to see how well the body is metabolizing the drink.

The researchers found that the higher the women's blood sugar levels, the more likely they were to have a cesarean delivery, to develop preeclampsia, to deliver prematurely or to have the delivery complication known as shoulder dystocia.

They also found that babies were affected by higher glucose levels and were more likely to have increased insulin, low blood sugar or to be born at a high birth weight.

The study did not determine when treatment should begin because the odds of complications changed continuously as blood sugar levels rose, the researchers reported. Women with the highest levels of blood sugar, but not diabetes, had large babies 26 percent of the time, for example, compared with just 5 percent for women with the lowest blood sugar levels.

"We were hoping there would be a break point," another of the study's authors, Dr. Don Coustan, professor and chairman of obstetrics and gynecology at Brown University's Warren Alpert Medical School, told HealthDay . "But, the relationship between glucose levels and outcomes were continuous, which means it will be difficult to decide where to put the 'treating' point."

Practical application of the study results, though, remains unclear.

"Basically, what they found out is that there is no threshold where you know to treat," Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City , told HealthDay . "That makes it difficult to know what to do with these findings."

On the Web

To learn more about diabetes and pregnancy, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

SOURCES: HealthDay News ; Boyd Metzger, M.D., Tom D. Spies professor of metabolism and nutrition, Feinberg School of Medicine, Northwestern University, Chicago; Don Coustan, M.D., professor and chairman, Department of Obstetrics/Gynecology, Warren Alpert Medical School of Brown University, and chief of obstetrics and gynecology, Women & Infants Hospital of Rhode Island, Providence, R.I.; Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, and professor of clinical medicine, Albert Einstein College of Medicine, New York City; May 8, 2008, New England Journal of Medicine ; U.S. Centers for Disease Control and Prevention (www.cdc.gov)
Author: Serena Gordon
Publication Date: May 31, 2009
Copyright © 2009 ScoutNews, LLC. All rights reserved.


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