Hypoglycemia during the oral glucose tolerance test in pregnancy—maternal characteristics and neonatal outcomes

Raviv, Shira; Wilkof-Segev, Renana; Maor‐Sagie, Esther; Naeh, Amir; Yoeli, Yochai; Hallak, Mordechai; Gabbay‐Benziv, Rinat

doi:10.1002/ijgo.14037

Cited by 5 publications

(6 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Meta-analysis of RCTs on the effects of probiotics on glycemia in pregnancy by Pan et al (2021) indicated that probiotic supplements improved FPG level (14 RCTs) and insulin resistance (HOMA-IR, 13 RCTs), specifically in GDM and healthy pregnant women, which is in trend with our results regarding nutritional supplements and improved levels of FPG and HOMA-IR [ 52 ]. Maternal age is a known confounder of glucose status with dysglycemic individuals typically older [ 53 ]. Our results suggest that nutritional supplements are less effective in reducing insulin resistance in the higher maternal age subgroup, as this group might have more severe dysglycemia.…”

Section: Discussionmentioning

confidence: 99%

“…Subgroup analysis suggested that common moderators of GDM risk do not modify the effectiveness of dietary interventions on dysglycemia, except for lower maternal age, ADA diagnostic criteria, and a non-western country. Pregnant women with lower maternal age are less likely to suffer from severe dysglycemia; thus, interventions might be more effective and insulin resistance might be easier to improve in this subgroup [ 53 ]. All non-western country studies used ADA guidelines as diagnostic criteria, suggesting a disagreement of diagnostic criteria as a previous study found IADPSG (i.e., ADA) criteria more favorable than NICE for identification of adverse pregnancy outcomes among Asian and Hispanic women, while they are comparable to NICE among White women [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Nutritional and Exercise-Focused Lifestyle Interventions and Glycemic Control in Women with Diabetes in Pregnancy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

et al. 2023

View full text Add to dashboard Cite

Diabetes disrupts one in six pregnancies, bestowing immediate and long-term health risks to mother and child. Diet and exercise are commonly prescribed to control dysglycemia, but their effectiveness across sub-populations and types of diabetes (type-1; type-2; or gestational diabetes mellitus, GDM) is uncertain. Therefore, a systematic review and meta-analysis on the effect of diet and/or exercise on glycemia in pregnant women with diabetes was conducted. Random effects models were used to evaluate effect sizes across studies and anticipated confounders (e.g., age, ethnicity, BMI). Of the 4845 records retrieved, 26 studies (8 nutritional supplements, 12 dietary, and 6 exercise interventions) were included. All studies were conducted in patients with GDM. Overall, supplement- and exercise-based interventions reduced fasting glucose (−0.30 mmol/L; 95% CI = −0.55, −0.06; p = 0.02; and 0.10 mmol/L; 95% CI = −0.20, −0.01; p = 0.04); and supplement- and diet-based interventions reduced HOMA-IR (−0.40; 95% CI = −0.58, −0.22; p < 0.001; and −1.15; 95% CI = −2.12, −0.17; p = 0.02). Subgroup analysis by confounders only confirmed marginal changed effect sizes. Our results suggest a favorable role of certain nutritional supplements, diet, and exercise practices on glycemia in women with GDM and underline a lack of evidence in ~20% of other diabetes-related pregnancies (i.e., women with pre-existing diabetes).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nutritional and Exercise-Focused Lifestyle Interventions and Glycemic Control in Women with Diabetes in Pregnancy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

et al. 2023

View full text Add to dashboard Cite

show abstract

“…However, only few studies have focused on the potential relationship between low glycemia during the oral glucose tolerance test (OGTT) and the impact on maternal and neonatal outcomes in normal glucose tolerant (NGT) women. Studies focused mostly on the effects of reactive hypoglycemia during an OGTT (7,8,(12)(13)(14)(15)(16) and data are limited on the potential effects of lower glycemic values in general. In addition, these studies reported conflicting results concerning the impact on maternal and neonatal outcomes, especially on neonatal birth weight (7,(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

“…Studies focused mostly on the effects of reactive hypoglycemia during an OGTT (7,8,(12)(13)(14)(15)(16) and data are limited on the potential effects of lower glycemic values in general. In addition, these studies reported conflicting results concerning the impact on maternal and neonatal outcomes, especially on neonatal birth weight (7,(12)(13)(14). Moreover, most studies investigated the effects of hypoglycemia in women with GDM or obesity (12,14,16,17).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, these studies reported conflicting results concerning the impact on maternal and neonatal outcomes, especially on neonatal birth weight (7,(12)(13)(14). Moreover, most studies investigated the effects of hypoglycemia in women with GDM or obesity (12,14,16,17). Data are sparse on pregnancy outcomes of NGT women with a lower glycemic value measured during the OGTT between 24-28 weeks of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Normal glucose tolerant women with low glycemia during the oral glucose tolerance test have a higher risk to deliver a low birth weight infant

Raets,

Van Doninck,

Van Crombrugge

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

BackgroundData are limited on pregnancy outcomes of normal glucose tolerant (NGT) women with a low glycemic value measured during the 75g oral glucose tolerance test (OGTT). Our aim was to evaluate maternal characteristics and pregnancy outcomes of NGT women with low glycemia measured at fasting, 1-hour or 2-hour OGTT.MethodsThe Belgian Diabetes in Pregnancy-N study was a multicentric prospective cohort study with 1841 pregnant women receiving an OGTT to screen for gestational diabetes (GDM). We compared the characteristics and pregnancy outcomes in NGT women according to different groups [(<3.9mmol/L), (3.9-4.2mmol/L), (4.25-4.4mmol/L) and (>4.4mmol/L)] of lowest glycemia measured during the OGTT. Pregnancy outcomes were adjusted for confounding factors such as body mass index (BMI) and gestational weight gain.ResultsOf all NGT women, 10.7% (172) had low glycemia (<3.9 mmol/L) during the OGTT. Women in the lowest glycemic group (<3.9mmol/L) during the OGTT had compared to women in highest glycemic group (>4.4mmol/L, 29.9%, n=482), a better metabolic profile with a lower BMI, less insulin resistance and better beta-cell function. However, women in the lowest glycemic group had more often inadequate gestational weight gain [51.1% (67) vs. 29.5% (123); p<0.001]. Compared to the highest glycemia group, women in the lowest group had more often a birth weight <2.5Kg [adjusted OR 3.41, 95% CI (1.17-9.92); p=0.025].ConclusionWomen with a glycemic value <3.9 mmol/L during the OGTT have a higher risk for a neonate with birth weight < 2.5Kg, which remained significant after adjustment for BMI and gestational weight gain.

show abstract

Antenatal maternal hypoglycemia in women with gestational diabetes mellitus and neonatal outcomes

Harrison¹,

Saravanan

Davitt

et al. 2022

J Perinatol

View full text Add to dashboard Cite

Hypoglycemia during the oral glucose tolerance test in pregnancy—maternal characteristics and neonatal outcomes

Cited by 5 publications

References 19 publications

Nutritional and Exercise-Focused Lifestyle Interventions and Glycemic Control in Women with Diabetes in Pregnancy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Nutritional and Exercise-Focused Lifestyle Interventions and Glycemic Control in Women with Diabetes in Pregnancy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Normal glucose tolerant women with low glycemia during the oral glucose tolerance test have a higher risk to deliver a low birth weight infant

Antenatal maternal hypoglycemia in women with gestational diabetes mellitus and neonatal outcomes

Contact Info

Product

Resources

About