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Gestational Diabetes:: A Field of Controversy

Vidaeff, Alex C. MD, MPH*; Yeomans, Edward R. MD; Ramin, Susan M. MD

Obstetrical & Gynecological Survey: November 2003 - Volume 58 - Issue 11 - p 759-769
doi: 10.1097/01.OGX.0000093782.25261.AC
CME PROGRAM: CATEGORY 1 CME REVIEW ARTICLES 29, 30, 31 AND 32: CME REVIEW ARTICLE 31
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Many clinicians in the United States routinely screen all pregnant women in their practices for gestational diabetes. Recently, the US Preventive Services Task Force re-emphasized that such screening is not supported by rigorous scientific evidence. Recommendations for diagnosis and management are based on an even scantier scientific foundation. Although this review questions several aspects of current dogma, it, too, is based on the frequently flawed existing data. It is surprising how, in spite of an abundance of published information on the subject, we continue to be ignorant of the real benefits of the widespread practice of screening and treating for gestational diabetes. The authors hope that the results of a randomized clinical trial, now in progress, will help to resolve some of the controversies surrounding gestational diabetes.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader should be able to describe the controversy surrounding the significance of gestational diabetes, to break down the data regarding the efficacy of screening for gestational diabetes, and to outline potential treatment options for gestational diabetes.

*Associate Professor, †Associate Professor, Director of the Residency Program at Lyndon B. Johnson General Hospital, ‡Associate Professor, Director, Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas-Houston Medical School, Houston, Texas

Chief Editor’s Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credit hours can be earned in 2003. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

Correspondence to: Alex C. Vidaeff, MD, Department of Obstetrics, Gynecology and Reproductive Sciences, 6431 Fannin, Suite 3.604, Houston, TX 77030. E-mail: alex.c.vidaeff@uth.tmc.edu

The authors have disclosed that the use of glyburide, glipizide, gllmepride, nosigltazone, ploglitazone, tolbutamide, acetohexamide, tolazamide, chlorpropamide, repagllnide, nategllnide, and acarbose has not been approved by the U.S. Food and Drug Administration for use during pregnancy as discussed in this article. Please consult product labeling for approved uses.

The authors have disclosed no significant financial or other relationship wtih any commercial entity.

© 2003 Lippincott Williams & Wilkins, Inc.