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OR: Pregnancy—Clinical/Epidemiology| June 14 2024

258-OR: The Effect of Early Initiation of Treatment on Glycemia and Pregnancy Outcomes in Women with Early Gestational Diabetes Mellitus

JINCY IMMANUEL;

JINCY IMMANUEL

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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WILLIAM HAGUE;

WILLIAM HAGUE

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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ARIANNE SWEETING;

ARIANNE SWEETING

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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VINCENT W.M. WONG;

VINCENT W.M. WONG

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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EMILY HIBBERT;

EMILY HIBBERT

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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EMILY J. GIANATTI;

EMILY J. GIANATTI

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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MICHAEL J. PEEK;

MICHAEL J. PEEK

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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HELENA TEEDE;

HELENA TEEDE

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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VISWANATHAN MOHAN;

VISWANATHAN MOHAN

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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N. WAH CHEUNG;

N. WAH CHEUNG

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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CHRISTOPHER J. NOLAN;

CHRISTOPHER J. NOLAN

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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ALEXANDRA KAUTZKY-WILLER;

ALEXANDRA KAUTZKY-WILLER

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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JÜRGEN HARREITER;

JÜRGEN HARREITER

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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HELENA E. BACKMAN;

HELENA E. BACKMAN

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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DAVID SIMMONS

DAVID SIMMONS

Denton, TX, North Adelaide, Australia, SYDNEY, Australia, Liverpool, Australia, Kingswood, Australia, Palmyra DC, Australia, Canberra, Australia, Melbourne, Australia, Chennai, India, Woden, Australia, Vienna, Austria, Örebro, Sweden, Campbelltown NSW, Australia

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Diabetes 2024;73(Supplement_1):258-OR

https://doi.org/10.2337/db24-258-OR

Aim: To compare maternal glycemia and pregnancy outcomes with treatment initiation before 20 weeks’ versus after 24 weeks' gestation among women with early gestational diabetes mellitus (EGDM).

Methods: This prospective study included participants enrolled in the Treatment of Booking Gestational Diabetes Mellitus randomized controlled trial. Women diagnosed with GDM were provided with an Accu-Chek Guide glucose meter and instructed to monitor capillary blood glucose (BG) 4 times/day (fasting and 2-h post-prandial). Optimal glycemia was defined as 95% of BG measurements between 3.5 and 7.8 mmol/l. Pregnancy complications comprised a composite of preterm birth, macrosomia, birth trauma, respiratory distress, phototherapy, stillbirth/neonatal death, and/or shoulder dystocia.

Results: 120,677 BG values (mean n=302, 13.2±6.9 weeks’ duration) were obtained from 399 women (mean age 32.4±4.9 years, BMI 31.4±7.8 kg/m², 36% European, gestation at GDM diagnosis 15.2±2.4 weeks’). Optimal glycemia was achieved in 72% of women; associated with reduced complications (>95% BGs optimal: 23.6%, 90-95% optimal: 31.3%, <90% optimal: 45.5%; p=0.007). Complications were less in women with lower mean fasting glucose (MFG) (<5.0 mmol/l: 17.1%, 5.0-5.2 mmol/l: 30.9%, 5.3-5.5 mmol/l: 25.6%, >5.6 mmol/l: 41.7%; p=0.009). Women with EGDM treated early (n=213) showed lower mean glucose (MG) and MFG compared with those treated late (n=116) (MG: 5.7±0.4 vs. 5.9±0.5, p<0.001, MFG: 5.2±0.3 vs. 5.3±0.4; p=0.004), with greater optimal glycemia (95.9% vs. 93.8%, respectively; p=0.04). Similar findings were seen in the second and third trimesters.

Conclusion: Early initiation of treatment in women with EGDM can improve subsequent maternal glycemia and reduce adverse pregnancy outcomes.

Disclosure

J. Immanuel: None. W. Hague: None. A. Sweeting: None. V.W.M. Wong: None. E. Hibbert: None. E.J. Gianatti: None. M.J. Peek: None. H. Teede: None. V. Mohan: None. N. Cheung: None. C.J. Nolan: None. A. Kautzky-Willer: None. J. Harreiter: None. H.E. Backman: None. D. Simmons: Speaker's Bureau; Abbott. Consultant; Sanofi. Speaker's Bureau; Ascensia Diabetes Care. Other Relationship; Ascensia Diabetes Care, Boehringer-Ingelheim. Research Support; Dexcom, Inc. Speaker's Bureau; Novo Nordisk. Research Support; Wests Club, NSW, Australia, Roche Diabetes Care.

Funding

National Health and Medical Research Council (NHMRC) (grants 1104231 and 2009326); Region Örebro Research Committee Dnr OLL-970566, OLL-942177; Medical Scientific Fund of the Mayor of Vienna, project 15205; South Western Sydney Local Health District Academic Unit grant 2016; Western Sydney University Ainsworth Trust grant 2019; Roche supplied glucose meters for the TOBOGM trial and provided access to the data.

© 2024 by the American Diabetes Association

2024

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