Glycemic Targets for Pregnant Women With GDM and T2DM
Glycemic Targets for Pregnant Women With GDM and T2DM
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.
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