IDEAL: Investigation of Dietary Advice and lifestyle for women with borderline Gestational Diabetes Mellitus.

This trial is currently recruiting.

With the publication of the ACHOIS trial it is now clear that treatment of pregnant women with mild gestational diabetes, formerly defined as impaired glucose tolerance, is beneficial for women and their infants (Crowther et al 2005). There remains, however, a lack of high quality evidence as to whether the benefits of similar treatment for women with borderline gestational glucose intolerance outweigh any harms. The recent report of a randomised trial in women who had a positive oral glucose challenge test and a subsequent normal oral glucose tolerance test and received treatment with dietary advice and blood glucose monitoring showed promising results, in that the risk of macrosomia was reduced (Bonomo et al 2005). However there are insufficient data from this or other studies about clinically important health outcomes such as other infant morbidity, maternal physical and psychological morbidity and costs to enable informed decision-making. The aims of this large, multicentre randomised clinical trial are to assess whether treatment of dietary and lifestyle advice, given to pregnant women who have borderline glucose intolerance on screening for gestational diabetes, (defined as a positive oral glucose challenge screening test followed by a normal oral glucose tolerance test), reduces neonatal complications without increasing maternal risks, and whether resources should be allocated for such treatment.

Reference

Dodd JM, Crowther CA, Antoniou G, Baghurst P, Robinson JR. Screening for gestational diabetes: the effect of varying blood glucose definitions in the prediction of adverse maternal and infant health outcomes. Aust N Z J Obstet Gynaecol. 2007 Aug;47(4):307-12. (IF 0.835)