Very tight versus tight control for diabetes in pregnancy

Sources of evidence for systematic reviews of interventions in diabetes

“…After checking, 44 systematic reviews of diabetes interventions which met our inclusion criteria were obtained [3,12–54]: 14 (32%) were Cochrane reviews and 30 (68%) were journal articles. Forty‐five per cent were reviews of drug interventions.…”

Sources of evidence for systematic reviews of interventions in diabetes

“…After checking, 44 systematic reviews of diabetes interventions which met our inclusion criteria were obtained [3,12–54]: 14 (32%) were Cochrane reviews and 30 (68%) were journal articles. Forty‐five per cent were reviews of drug interventions.…”

Vitamin E Supplement Protects Against Gestational Diabetes Mellitus in Mice Through nuclear factor-erythroid factor 2-related factor 2/heme oxygenase-1 Signaling Pathway

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Poor glycated haemoglobin control and adverse pregnancy outcomes in type 1 and type 2 diabetes mellitus: Systematic review of observational studies

“…There are limited randomised trial data on the impact of different levels of glycaemic control on outcome in diabetic pregnancies [ 27 ]. The randomised, prospective Diabetes Control and Complications Trial (DCCT) has shown that timely institution of intensive therapy for blood glucose control is associated with rates of spontaneous abortion and congenital malformations that are similar to those in the non-diabetic populations [ 28 ].…”

“…A Cochrane systematic review of randomised trials comparing very tight with tight control of diabetes in pregnancy focused on two trials involving a total of 182 women. The conclusion was that there was no clear evidence of benefit from very tight versus tight glycaemic control for pregnant women with diabetes [ 27 ]. Observational studies show much less favourable outcomes in unselected populations.…”

“…There remains an urgent need to address the maternal and perinatal benefits of varying degrees of control of blood sugar for pregnant women with diabetes. Outcome measures should be standardised and include important factors associated with poor perinatal and maternal outcomes, such as pre-eclampsia, macrosomia, caesarean section, shoulder dystocia, perinatal loss, neonatal respiratory and metabolic complications [ 27 ]. Future studies also need to investigate the issue of pre-conceptual glycaemic control and post pregnancy outcomes for the mother.…”

Sources of evidence for systematic reviews of interventions in diabetes

“…After checking, 44 systematic reviews of diabetes interventions which met our inclusion criteria were obtained [3,12–54]: 14 (32%) were Cochrane reviews and 30 (68%) were journal articles. Forty‐five per cent were reviews of drug interventions.…”

Vitamin E Supplement Protects Against Gestational Diabetes Mellitus in Mice Through nuclear factor-erythroid factor 2-related factor 2/heme oxygenase-1 Signaling Pathway

“……”

Poor glycated haemoglobin control and adverse pregnancy outcomes in type 1 and type 2 diabetes mellitus: Systematic review of observational studies

“…There are limited randomised trial data on the impact of different levels of glycaemic control on outcome in diabetic pregnancies [ 27 ]. The randomised, prospective Diabetes Control and Complications Trial (DCCT) has shown that timely institution of intensive therapy for blood glucose control is associated with rates of spontaneous abortion and congenital malformations that are similar to those in the non-diabetic populations [ 28 ].…”

“…A Cochrane systematic review of randomised trials comparing very tight with tight control of diabetes in pregnancy focused on two trials involving a total of 182 women. The conclusion was that there was no clear evidence of benefit from very tight versus tight glycaemic control for pregnant women with diabetes [ 27 ]. Observational studies show much less favourable outcomes in unselected populations.…”

“…There remains an urgent need to address the maternal and perinatal benefits of varying degrees of control of blood sugar for pregnant women with diabetes. Outcome measures should be standardised and include important factors associated with poor perinatal and maternal outcomes, such as pre-eclampsia, macrosomia, caesarean section, shoulder dystocia, perinatal loss, neonatal respiratory and metabolic complications [ 27 ]. Future studies also need to investigate the issue of pre-conceptual glycaemic control and post pregnancy outcomes for the mother.…”

Sources of evidence for systematic reviews of interventions in diabetes

“…After checking, 44 systematic reviews of diabetes interventions which met our inclusion criteria were obtained [3,12–54]: 14 (32%) were Cochrane reviews and 30 (68%) were journal articles. Forty‐five per cent were reviews of drug interventions.…”

Vitamin E Supplement Protects Against Gestational Diabetes Mellitus in Mice Through nuclear factor-erythroid factor 2-related factor 2/heme oxygenase-1 Signaling Pathway

“……”

Poor glycated haemoglobin control and adverse pregnancy outcomes in type 1 and type 2 diabetes mellitus: Systematic review of observational studies

“…There are limited randomised trial data on the impact of different levels of glycaemic control on outcome in diabetic pregnancies [ 27 ]. The randomised, prospective Diabetes Control and Complications Trial (DCCT) has shown that timely institution of intensive therapy for blood glucose control is associated with rates of spontaneous abortion and congenital malformations that are similar to those in the non-diabetic populations [ 28 ].…”

“…A Cochrane systematic review of randomised trials comparing very tight with tight control of diabetes in pregnancy focused on two trials involving a total of 182 women. The conclusion was that there was no clear evidence of benefit from very tight versus tight glycaemic control for pregnant women with diabetes [ 27 ]. Observational studies show much less favourable outcomes in unselected populations.…”

“…There remains an urgent need to address the maternal and perinatal benefits of varying degrees of control of blood sugar for pregnant women with diabetes. Outcome measures should be standardised and include important factors associated with poor perinatal and maternal outcomes, such as pre-eclampsia, macrosomia, caesarean section, shoulder dystocia, perinatal loss, neonatal respiratory and metabolic complications [ 27 ]. Future studies also need to investigate the issue of pre-conceptual glycaemic control and post pregnancy outcomes for the mother.…”