Early diagnosis, treatment of diabetes in pregnant women benefit infants: study

Lead author David Simmons says the study provided new evidence for those deemed to be at higher risk for early testing and treatment of gestational diabetes beyond the current recommended approach of intervening at 24-28 weeks

Published - May 07, 2023 03:00 am IST - CHENNAI

Image for representation purpose only.

Image for representation purpose only.

Early diagnosis and treatment of gestational diabetes mellitus results in additional protection for babies and mothers from pregnancy complications, as per the results of a multi-centric, randomised controlled trial (RCT) published recently in the New England Journal of Medicine.

The study, named TOBOGM, was performed at 17 hospitals in Australia, Austria, Sweden and India; recruited 802 women with a diabetes risk factor before 20 weeks’ gestation. Gestational Diabetes Mellitus (GDM) is a form of diabetes which is first diagnosed during pregnancy.

Lead author David Simmons from the Western Sydney University’s School of Medicine and Translational Health Research Institute said the study provided new evidence for those deemed to be at higher risk for early testing and treatment of gestational diabetes beyond the current recommended approach of intervening at 24-28 weeks.

The study assessed pregnancy outcomes with the initiation of treatment for GDM before 20 weeks, compared with no early treatment and subsequent initiation of treatment at 24-28 weeks gestation. “Over one in 20 babies avoided a group of severe birth complications including birth damage like broken bones or nerves, or getting stuck during birth. In addition, breathing problems requiring oxygen were almost halved and the number of days needed in neonatal intensive care or special care unit was down by 40%,” Prof. Simmons explained.

‘A game changer’

From Chennai, the Madras Diabetes Research Foundation and Seethapathy Clinic, an obstetric care centre, were part of the global study. MDRF chairman V. Mohan said the TOBOGM study is a clear game changer. It gives a clear indication that screening for, and treatment of early gestational diabetes mellitus is beneficial. He hoped that this study would result in revising (timing of) diagnosis and treatment for GDM, across the world. “Increasing awareness about GDM is very important as it can help to improve the lives of not only the mother, but also her offspring,” added Guha Pradeepa, Research Scientist, MDRF, who coordinated the study.

Uma Ram of Seethapathy Clinic said, “The TOBOGM study will help in earlier diagnosis and management of GDM which today affects at least 25%, i.e. one in four of all pregnant women”. R.M. Anjana, president, MDRF, pointed out that in India, screening for GDM in the first trimester has already been part of the guidelines, but, TOBOGM provides the first RCT-based evidence that treatment in the first trimester of GDM is not only beneficial but free of any significant adverse effects.

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