Early screening of gestational diabetes helps with treatment: Study

CHENNAI: While the current guidelines recommend screening for Gestational Diabetes Mellitus (GDM) between the 24th and 28th week of pregnancy, a recent study published in the New England Journal of Medicine states that screening at an earlier stage in pregnancy helps to rule out a pre-existing condition and allows for treatment.

The study titled, ‘Treatment of Booking Gestational Diabetes Mellitus (TOBOGM)’ is the first multicentre randomised clinical trial of diagnosis and treatment of hyperglycaemia in pregnant women before 20 weeks’ gestation.

The study was done in 16 sites including the Madras Diabetes Research Foundation (MDRF).

“The aim of TOBOGM was to understand the treatment effects of diagnosis and treating early GDM also called as booking GDM,” said the Principal Investigator of TOBOGM study, Prof David Simmons, Medicine and Specialist Endocrinologist at Western Sydney University, Sydney, Australia/Campbelltown Hospital.

In the study, women attending antenatal clinics underwent an early Oral Glucose Tolerance Test (OGTT) before 20 weeks of gestation. Those women who were diagnosed to have pre-existing diabetes or pre-diabetes were excluded.

However, those who were diagnosed to have early GDM were randomised into two groups – intervention group of 400 women and a control group of 400 women. The intervention group received treatment for GDM as per the practice of standard treatment. The control group of women with early GDM were not given any treatment.

The results showed that the group that received treatment had low outcomes of birth trauma and reduction in the number of days in the neonatal ICU. There was no difference in the pregnancy hypertensive disorders or neonatal lean body mass between the two treatment groups.

Dr V Mohan, chairman, MDRF, said: “The study is a game-changer in the field of GDM. It gives a clear indication that screening for GDM helps with treating it.”

Dr Uma Ram, Seethapathy Clinic, Chennai, an active collaborator in the trial, said, “The TOBOGM study will help in earlier diagnosis and management of GDM which affects at least 25% of all pregnant women.”