In response to the queries to the list about this condition.
There are people conducting research on the appropriate approach to the
management of this condition.
Together with Caroline Crowther (Obstetrician), John Moss (economist) and a
number of collaborators around Australia and in the UK, I am conducting a
randomised controlled trial on the effect of screening and management of
glucose intolerance of pregnancy. Women with a raised GCT are approached re
participation in the trial. If they consent, those women with an abnormal
GTT are randomised to one of two groups. In the first treatment group,
women and their health care providers are informed of the GTT results and
are actively managed and labelled. Women randomised to the comparison group
are informed that they do not have gestational diabetes. As those women who
consented following the GCT who do not have an abnormal GTT are also
informed that they do not have gestational diabetes they women in the
comparison group are effectively masked. These women receive routine
antenatal care - if the health care provider wants to order additional GTTs
then they go ahead and do so.
We are investigating maternal and infant physical morbidity, costs and the
psychosocial consequences of the active labelling of the condition.
We hope to randomise approximately 1,000 women although we are finding the
predictive value of the GCT very poor and as a result large numbers of
women are approached re the trial (+ consented) for a far smaller number
actually randomised.
There is tremendous variation in screening practices which will continue in
the absence of systematic research.
Janet E. Hiller, PhD
Department of Public Health
University ofAdelaide, Adelaide SA
Australia 5005
+ 61 8 8303 3573 (ph) +61 8 8223 4075 (fax)
[log in to unmask]
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