Controlling moderately elevated blood sugar levels during pregnancy

This article reviewed the outcomes of interventions to control moderately elevated blood sugar levels during pregnancy.

During pregnancy, some women have high blood sugar that cannot be classified as gestational diabetes mellitus (GDM) or type 2 diabetes mellitus (T2DM). Elevated blood sugar levels can lead to complications both for the mother and child. Infants may have macrosomia (over 4 kg at birth), be large-for-gestational-age (LGA), require neonatal intensive care and have an increased risk of obesity and its complications later in life. Women are prone to pre-eclampsia (high blood pressure and loss of protein in the urine)  complications during labor and may later develop T2DM. Babies with macrosomia often need to be delivered via cesarean section. Currently, lowering blood sugar levels in patients without GDM or T2DM is controversial.

The authors reviewed data from 521 patients pooled from 4 clinical trials. All of them had elevated blood sugar without meeting GDM or T2DM criteria. The benefits of interventions to reduce blood sugar levels were compared to routine pregnancy care. Results showed that dietary changes, blood sugar monitoring and insulin therapy lowered the number of babies with macrosomia or LGA. There was no significant difference in the number of cesarean sections between women receiving interventions versus routine care.

Conclusions from this review support controlling high blood sugar levels in all pregnancies.

However, the patient sample was small and data came from 4 separate trials with different research methods. Larger trials are needed to confirm these results.