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Glycemic Targets for Pregnant Women With GDM and T2DM

Primary Purpose

Diabetes Mellitus in Pregnancy, Diabetes, Gestational, Diabetes Mellitus, Type 2

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Glycemic Targets
Sponsored by
University of Southern California
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus in Pregnancy

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Pregnant women with a singleton gestation
  • 18 years or older
  • Diagnosis of gestational diabetes (prior to 34 weeks gestational age) or Type 2 diabetes

Exclusion Criteria:

  • Diagnosed with gestational diabetes at or beyond 34 weeks gestational age
  • Type 1 diabetes
  • Diabetic retinopathy
  • Diabetic nephropathy
  • Diabetic vasculopathy

Sites / Locations

  • Los Angeles County + University of Southern California Medical Center (LAC+USC)Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Experimental

Arm Label

Control Arm

Interventional Arm

Arm Description

Patients in the control arm will be instructed to check blood sugars seven times per day: fasting, pre-prandial, and 1 hour after each meal. The glycemic targets for the control arm will be defined as follows: fasting ≤95 mg/dL, pre-prandial ≤95 mg/dL, and 1-hour postprandial ≤140 mg/dL (i.e. conventional targets). Patients who do not achieve glycemic goals with diet and exercise will be started on medical therapy (metformin or insulin) at the discretion of a maternal-fetal medicine subspecialist and endocrinologist.

Patients in the experimental arm will be instructed to check blood sugars seven times per day: fasting, pre-prandial, and 1 hour after each meal. The glycemic targets for the intervention arm will be defined as follows: fasting ≤80 mg/dL, pre-prandial ≤80 mg/dL, and 1-hour postprandial ≤110 mg/dL. Patients who do not achieve glycemic goals with diet and exercise will be started on medical therapy (metformin or insulin) at the discretion of a maternal-fetal medicine subspecialist and endocrinologist.

Outcomes

Primary Outcome Measures

Difference in birth weight
250-gram difference in birth weight

Secondary Outcome Measures

Total prenatal care visits
Total number of prenatal care visits during pregnancy
Prenatal care visits after enrollment
Number of prenatal care visits after enrollment
Prenatal care visits: log/glucometer
Number of prenatal care visits with log/glucometer available for RN or MD to review
Prenatal care visits: targets met
Number of prenatal care visits in which patient met blood sugar targets
Prenatal care visits: intervention
Number of prenatal care visits in which an intervention for blood sugars was recommended (e.g. starting medication or changing medication dose)
Symptomatic hypoglycemia
Frequency of symptomatic hypoglycemia episodes (hypoglycemia defined as <70 mg/dL per ADA)
Asymptomatic hypoglycemia
Frequency of asymptomatic hypoglycemia episodes (hypoglycemia defined as <70 mg/dL per ADA)
A1c enrollment
Hemoglobin A1c at the time of enrollment
A1c 36 weeks
Hemoglobin A1c at 36 weeks gestational age
Lowest recorded blood sugar
Lowest recorded blood sugar during prenatal care
Highest recorded blood sugar
Highest recorded blood sugar during prenatal care
Average recorded blood sugar
Average recorded blood sugar during prenatal care
Weekly compliance
Average number of blood sugar checks actually performed each week
Weekly target assessment
% of blood sugars within goal each week
Diabetes medication
Did the patient need diabetes medication (including oral agents and insulin) during antepartum period?
Intrapartum insulin
Did the patient need insulin during the intrapartum period?
Gestational weight gain
Total weight gain during pregnancy in kilograms
Antepartum admission
Was the patient ever admitted to antepartum service for any indication, including poorly-controlled diabetes or diabetes-related complication?
Corticosteroids
Did the patient receive antenatal corticosteroid treatment?
Oligohydramnios
Amniotic fluid index <5 cm or maximum vertical pocket <2cm
Polyhydramnios
Amniotic fluid index >24cm or maximum vertical pocket >8cm
Fetal growth restriction
Ultrasonographic estimated fetal weight or abdominal circumference <10% for gestational ag
Gestational age at delivery
Gestational age at delivery
Induction of labor
Did the patient undergo induction of labor?
Mode of delivery
primary cesarean section, repeat cesarean section, vaginal delivery, vaginal delivery with vacuum, vaginal delivery with forceps
Cesarean indication
If the patient had cesarean delivery, what was the indication?
TOLAC
Did the patient attempt a trial of labor after cesarean?
Blood loss
Quantitative blood loss (or estimated if quantitative is unknown) in cc's
3rd or 4th degree laceration
3rd or 4th degree perineal laceration
PIH
Pregnancy-induced hypertension (gestational hypertension, preeclampsia, HELLP syndrome)
Hypertensive emergency
Did the patient have severe-range blood pressures require antihypertensive medication?
Chorioamnionitis
Chorioamnionitis
Endometritis
Endometritis
VTE
Venous thromboembolism: deep venous thrombosis or pulmonary embolism
Length of stay (maternal)
Length of hospital admission for labor, delivery, and postpartum
Postpartum readmission
Did the patient get readmitted within 30 days of delivery?
Postpartum wound complication
Cesarean wound infection of dehiscence, perineal laceration breakdown
Cardiac complications
Did the patient develop any cardiac complications such as arrhythmias or cardiomyopathy?
Seizures
Did any maternal seizures occur during the pregnancy or postpartum?
Macrosomia
Birth weight >4000 grams
LGA
Large for gestational age (birth weight ≥90% for gestational age)
SGA
Small for gestational age (birth weight <10% for gestational age)
Shoulder dystocia
Shoulder dystocia
Apgar
5-minute Apgar score
Cord gas pH <7.0
Did the baby have a cord blood gas pH <7.0?
Base excess
What was the base excess on the cord blood gas?
Neonatal blood glucose
What was the neonatal serum blood glucose at birth?
RDS
Neonatal respiratory distress syndrome
TTN
Transient tachypnea of the newborn
Hyperbilirubinemia
Neonatal hyperbilirubinemia (as defined in AAP 2004 Clinical Practice Guideline "Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation")
Neonatal sepsis
Neonatal sepsis
NICU
NICU admission
Length of stay (neonatal)
How many days after birth did the neonate stay in the hospital?
Congenital anomaly
Congenital anomaly
IUFD or stillbirth
Intrauterine fetal demise or stillbirth

Full Information

First Posted
December 8, 2020
Last Updated
May 9, 2023
Sponsor
University of Southern California
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1. Study Identification

Unique Protocol Identification Number
NCT04672031
Brief Title
Glycemic Targets for Pregnant Women With GDM and T2DM
Official Title
Tight Versus Standard Glycemic Targets for Pregnant Women With Gestational Diabetes and Type 2 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 8, 2021 (Actual)
Primary Completion Date
July 2023 (Anticipated)
Study Completion Date
July 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Southern California

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this randomized clinical trial is to determine whether glycemic targets that are lower than those currently recommended by the American Diabetes Association (ADA) and the American College of Obstetricians and Gynecologists (ACOG) would improve overall outcomes in pregnant patients with diabetes. Eligible pregnant women with a diagnosis of gestational diabetes or Type 2 diabetes will be randomized into either routine care with glycemic targets as currently recommended by ADA and ACOG (control arm), or more aggressive care with lower glycemic targets that more closely resemble normoglycemia in pregnancy (intervention arm). The glycemic targets for the control arm will be defined as follows: fasting ≤95 mg/dL, pre-prandial ≤95 mg/dL, and 1-hour postprandial ≤140 mg/dL. The glycemic targets for the intervention arm will be defined as follows: fasting ≤80 mg/dL, pre-prandial ≤80 mg/dL, and 1-hour postprandial ≤110 mg/dL. The primary outcome will be a 250-gram difference in birth weight between the two study arms. Secondary maternal and neonatal outcomes of interest will also be compared between the two study arms.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus in Pregnancy, Diabetes, Gestational, Diabetes Mellitus, Type 2

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Eligible women will be randomized at a 1:1 ratio (using block randomization) into either the control arm or the intervention arm. It is understood that study participants, physicians, and nurse-educators cannot be blinded to group allocation. The randomization process will proceed as follows. A primary randomization model assigning patients to the "New Target" versus the "Standard Target" will be created for the one center (LAC+USC), and permuted-block randomization with random allocation will be used. The investigators will be blinded to the block size. The generation of randomization codes will be performed using SAS statistical software, v. 9.3, Cary, NC. A validation test will be performed to assure that treatment balance is achieved within the entire study.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Control Arm
Arm Type
No Intervention
Arm Description
Patients in the control arm will be instructed to check blood sugars seven times per day: fasting, pre-prandial, and 1 hour after each meal. The glycemic targets for the control arm will be defined as follows: fasting ≤95 mg/dL, pre-prandial ≤95 mg/dL, and 1-hour postprandial ≤140 mg/dL (i.e. conventional targets). Patients who do not achieve glycemic goals with diet and exercise will be started on medical therapy (metformin or insulin) at the discretion of a maternal-fetal medicine subspecialist and endocrinologist.
Arm Title
Interventional Arm
Arm Type
Experimental
Arm Description
Patients in the experimental arm will be instructed to check blood sugars seven times per day: fasting, pre-prandial, and 1 hour after each meal. The glycemic targets for the intervention arm will be defined as follows: fasting ≤80 mg/dL, pre-prandial ≤80 mg/dL, and 1-hour postprandial ≤110 mg/dL. Patients who do not achieve glycemic goals with diet and exercise will be started on medical therapy (metformin or insulin) at the discretion of a maternal-fetal medicine subspecialist and endocrinologist.
Intervention Type
Other
Intervention Name(s)
Glycemic Targets
Intervention Description
The intervention is glycemic targets that are lower than those currently recommended by ADA and ACOG: fasting ≤80 mg/dL, pre-prandial ≤80 mg/dL, and 1-hour postprandial ≤110 mg/dL instead of fasting ≤95 mg/dL, pre-prandial ≤95 mg/dL, and 1-hour postprandial ≤140 mg/dL.
Primary Outcome Measure Information:
Title
Difference in birth weight
Description
250-gram difference in birth weight
Time Frame
41 weeks gestation
Secondary Outcome Measure Information:
Title
Total prenatal care visits
Description
Total number of prenatal care visits during pregnancy
Time Frame
41 weeks gestation
Title
Prenatal care visits after enrollment
Description
Number of prenatal care visits after enrollment
Time Frame
41 weeks gestation
Title
Prenatal care visits: log/glucometer
Description
Number of prenatal care visits with log/glucometer available for RN or MD to review
Time Frame
41 weeks gestation
Title
Prenatal care visits: targets met
Description
Number of prenatal care visits in which patient met blood sugar targets
Time Frame
41 weeks gestation
Title
Prenatal care visits: intervention
Description
Number of prenatal care visits in which an intervention for blood sugars was recommended (e.g. starting medication or changing medication dose)
Time Frame
41 weeks gestation
Title
Symptomatic hypoglycemia
Description
Frequency of symptomatic hypoglycemia episodes (hypoglycemia defined as <70 mg/dL per ADA)
Time Frame
41 weeks gestation
Title
Asymptomatic hypoglycemia
Description
Frequency of asymptomatic hypoglycemia episodes (hypoglycemia defined as <70 mg/dL per ADA)
Time Frame
41 weeks gestation
Title
A1c enrollment
Description
Hemoglobin A1c at the time of enrollment
Time Frame
At time of enrollment (up to 34 weeks gestation)
Title
A1c 36 weeks
Description
Hemoglobin A1c at 36 weeks gestational age
Time Frame
At 36 weeks gestational age
Title
Lowest recorded blood sugar
Description
Lowest recorded blood sugar during prenatal care
Time Frame
41 weeks gestation
Title
Highest recorded blood sugar
Description
Highest recorded blood sugar during prenatal care
Time Frame
41 weeks gestation
Title
Average recorded blood sugar
Description
Average recorded blood sugar during prenatal care
Time Frame
41 weeks gestation
Title
Weekly compliance
Description
Average number of blood sugar checks actually performed each week
Time Frame
41 weeks gestation
Title
Weekly target assessment
Description
% of blood sugars within goal each week
Time Frame
41 weeks gestation
Title
Diabetes medication
Description
Did the patient need diabetes medication (including oral agents and insulin) during antepartum period?
Time Frame
41 weeks gestation
Title
Intrapartum insulin
Description
Did the patient need insulin during the intrapartum period?
Time Frame
From onset of induction/labor until delivery
Title
Gestational weight gain
Description
Total weight gain during pregnancy in kilograms
Time Frame
41 weeks gestation
Title
Antepartum admission
Description
Was the patient ever admitted to antepartum service for any indication, including poorly-controlled diabetes or diabetes-related complication?
Time Frame
41 weeks gestation
Title
Corticosteroids
Description
Did the patient receive antenatal corticosteroid treatment?
Time Frame
41 weeks gestation
Title
Oligohydramnios
Description
Amniotic fluid index <5 cm or maximum vertical pocket <2cm
Time Frame
41 weeks gestation
Title
Polyhydramnios
Description
Amniotic fluid index >24cm or maximum vertical pocket >8cm
Time Frame
41 weeks gestation
Title
Fetal growth restriction
Description
Ultrasonographic estimated fetal weight or abdominal circumference <10% for gestational ag
Time Frame
41 weeks gestation
Title
Gestational age at delivery
Description
Gestational age at delivery
Time Frame
During intrapartum admission to Labor & Delivery
Title
Induction of labor
Description
Did the patient undergo induction of labor?
Time Frame
During intrapartum admission to Labor & Delivery
Title
Mode of delivery
Description
primary cesarean section, repeat cesarean section, vaginal delivery, vaginal delivery with vacuum, vaginal delivery with forceps
Time Frame
During intrapartum admission to Labor & Delivery
Title
Cesarean indication
Description
If the patient had cesarean delivery, what was the indication?
Time Frame
During intrapartum admission to Labor & Delivery
Title
TOLAC
Description
Did the patient attempt a trial of labor after cesarean?
Time Frame
During intrapartum admission to Labor & Delivery
Title
Blood loss
Description
Quantitative blood loss (or estimated if quantitative is unknown) in cc's
Time Frame
During intrapartum admission to Labor & Delivery
Title
3rd or 4th degree laceration
Description
3rd or 4th degree perineal laceration
Time Frame
During intrapartum admission to Labor & Delivery
Title
PIH
Description
Pregnancy-induced hypertension (gestational hypertension, preeclampsia, HELLP syndrome)
Time Frame
From 20 weeks gestation until 30 days postpartum
Title
Hypertensive emergency
Description
Did the patient have severe-range blood pressures require antihypertensive medication?
Time Frame
From conception until 30 days postpartum
Title
Chorioamnionitis
Description
Chorioamnionitis
Time Frame
During intrapartum admission to Labor & Delivery
Title
Endometritis
Description
Endometritis
Time Frame
Within 30 days postpartum
Title
VTE
Description
Venous thromboembolism: deep venous thrombosis or pulmonary embolism
Time Frame
From conception until 30 days postpartum
Title
Length of stay (maternal)
Description
Length of hospital admission for labor, delivery, and postpartum
Time Frame
From admission to Labor & Delivery until discharge from postpartum
Title
Postpartum readmission
Description
Did the patient get readmitted within 30 days of delivery?
Time Frame
Within 30 days postpartum
Title
Postpartum wound complication
Description
Cesarean wound infection of dehiscence, perineal laceration breakdown
Time Frame
Within 30 days postpartum
Title
Cardiac complications
Description
Did the patient develop any cardiac complications such as arrhythmias or cardiomyopathy?
Time Frame
From conception until 30 days postpartum
Title
Seizures
Description
Did any maternal seizures occur during the pregnancy or postpartum?
Time Frame
From conception until 30 days postpartum
Title
Macrosomia
Description
Birth weight >4000 grams
Time Frame
Within 24 hours of birth
Title
LGA
Description
Large for gestational age (birth weight ≥90% for gestational age)
Time Frame
Within 24 hours of birth
Title
SGA
Description
Small for gestational age (birth weight <10% for gestational age)
Time Frame
Within 24 hours of birth
Title
Shoulder dystocia
Description
Shoulder dystocia
Time Frame
During intrapartum admission to Labor & Delivery
Title
Apgar
Description
5-minute Apgar score
Time Frame
5 minutes after birth
Title
Cord gas pH <7.0
Description
Did the baby have a cord blood gas pH <7.0?
Time Frame
Within 24 hours of birth
Title
Base excess
Description
What was the base excess on the cord blood gas?
Time Frame
Within 24 hours of birth
Title
Neonatal blood glucose
Description
What was the neonatal serum blood glucose at birth?
Time Frame
Within 24 hours of birth
Title
RDS
Description
Neonatal respiratory distress syndrome
Time Frame
Within 30 days of delivery
Title
TTN
Description
Transient tachypnea of the newborn
Time Frame
Within 30 days of delivery
Title
Hyperbilirubinemia
Description
Neonatal hyperbilirubinemia (as defined in AAP 2004 Clinical Practice Guideline "Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation")
Time Frame
Within 30 days of delivery
Title
Neonatal sepsis
Description
Neonatal sepsis
Time Frame
Within 30 days of delivery
Title
NICU
Description
NICU admission
Time Frame
Within 30 days of delivery
Title
Length of stay (neonatal)
Description
How many days after birth did the neonate stay in the hospital?
Time Frame
From birth until discharge (up to 1 year)
Title
Congenital anomaly
Description
Congenital anomaly
Time Frame
Within 30 days of delivery
Title
IUFD or stillbirth
Description
Intrauterine fetal demise or stillbirth
Time Frame
From conception until delivery

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Pregnant women with a singleton gestation 18 years or older Diagnosis of gestational diabetes (prior to 34 weeks gestational age) or Type 2 diabetes Exclusion Criteria: Diagnosed with gestational diabetes at or beyond 34 weeks gestational age Type 1 diabetes Diabetic retinopathy Diabetic nephropathy Diabetic vasculopathy
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Brendan H Grubbs, MD
Phone
323-409-3306
Email
brendan.grubbs@med.usc.edu
Facility Information:
Facility Name
Los Angeles County + University of Southern California Medical Center (LAC+USC)
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michelle T Nguyen, MD
Phone
323-409-4084
Email
michelle.nguyen3@med.usc.edu

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
31856124
Citation
Macrosomia: ACOG Practice Bulletin, Number 216. Obstet Gynecol. 2020 Jan;135(1):e18-e35. doi: 10.1097/AOG.0000000000003606.
Results Reference
background
PubMed Identifier
29370047
Citation
ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstet Gynecol. 2018 Feb;131(2):e49-e64. doi: 10.1097/AOG.0000000000002501.
Results Reference
background
PubMed Identifier
29370044
Citation
ACOG Practice Bulletin No. 190 Summary: Gestational Diabetes Mellitus. Obstet Gynecol. 2018 Feb;131(2):406-408. doi: 10.1097/AOG.0000000000002498.
Results Reference
background
PubMed Identifier
9704245
Citation
Metzger BE, Coustan DR. Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. The Organizing Committee. Diabetes Care. 1998 Aug;21 Suppl 2:B161-7. No abstract available.
Results Reference
background
PubMed Identifier
25398204
Citation
Hernandez TL. Glycemic targets in pregnancies affected by diabetes: historical perspective and future directions. Curr Diab Rep. 2015 Jan;15(1):565. doi: 10.1007/s11892-014-0565-2.
Results Reference
background
PubMed Identifier
7612507
Citation
Fraser R. Diabetic control in pregnancy and intrauterine growth of the fetus. Br J Obstet Gynaecol. 1995 Apr;102(4):275-7. doi: 10.1111/j.1471-0528.1995.tb09130.x. No abstract available.
Results Reference
background
PubMed Identifier
6143065
Citation
Dandona P, Besterman HS, Freedman DB, Boag F, Taylor AM, Beckett AG. Macrosomia despite well-controlled diabetic pregnancy. Lancet. 1984 Mar 31;1(8379):737. doi: 10.1016/s0140-6736(84)92248-7. No abstract available.
Results Reference
background
PubMed Identifier
1425084
Citation
Combs CA, Gunderson E, Kitzmiller JL, Gavin LA, Main EK. Relationship of fetal macrosomia to maternal postprandial glucose control during pregnancy. Diabetes Care. 1992 Oct;15(10):1251-7. doi: 10.2337/diacare.15.10.1251.
Results Reference
background
PubMed Identifier
21709299
Citation
Hernandez TL, Friedman JE, Van Pelt RE, Barbour LA. Patterns of glycemia in normal pregnancy: should the current therapeutic targets be challenged? Diabetes Care. 2011 Jul;34(7):1660-8. doi: 10.2337/dc11-0241. No abstract available.
Results Reference
background
PubMed Identifier
8127526
Citation
Thompson DM, Dansereau J, Creed M, Ridell L. Tight glucose control results in normal perinatal outcome in 150 patients with gestational diabetes. Obstet Gynecol. 1994 Mar;83(3):362-6.
Results Reference
background
PubMed Identifier
7148898
Citation
Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982 Dec 1;144(7):768-73. doi: 10.1016/0002-9378(82)90349-0.
Results Reference
background
PubMed Identifier
8026282
Citation
Buchanan TA, Kjos SL, Montoro MN, Wu PY, Madrilejo NG, Gonzalez M, Nunez V, Pantoja PM, Xiang A. Use of fetal ultrasound to select metabolic therapy for pregnancies complicated by mild gestational diabetes. Diabetes Care. 1994 Apr;17(4):275-83. doi: 10.2337/diacare.17.4.275.
Results Reference
background
PubMed Identifier
11679455
Citation
Kjos SL, Schaefer-Graf U, Sardesi S, Peters RK, Buley A, Xiang AH, Bryne JD, Sutherland C, Montoro MN, Buchanan TA. A randomized controlled trial using glycemic plus fetal ultrasound parameters versus glycemic parameters to determine insulin therapy in gestational diabetes with fasting hyperglycemia. Diabetes Care. 2001 Nov;24(11):1904-10. doi: 10.2337/diacare.24.11.1904.
Results Reference
background
PubMed Identifier
31862757
Citation
American Diabetes Association. 14. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020 Jan;43(Suppl 1):S183-S192. doi: 10.2337/dc20-S014.
Results Reference
background
PubMed Identifier
15231951
Citation
American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004 Jul;114(1):297-316. doi: 10.1542/peds.114.1.297. Erratum In: Pediatrics. 2004 Oct;114(4):1138.
Results Reference
result
PubMed Identifier
30559232
Citation
American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019 Jan;42(Suppl 1):S61-S70. doi: 10.2337/dc19-S006.
Results Reference
result

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Glycemic Targets for Pregnant Women With GDM and T2DM

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