Early Screening and Treatment of Women with Prediabetes: A Randomized Controlled Trial

Objective  To examine whether women with prediabetes benefit from early treatment for gestational diabetes mellitus (GDM). Study Design  Women with a glycosylated hemoglobin A1C (A1C) of 5.7 to 6.4% at Results  Between May 2012 and June 2014, 95 women were enrolled and 83 had data for analysis; 42 were randomized to treatment and 41 to usual care. The groups were similar in baseline characteristics with 40% obese. There was no difference in the primary outcome (treatment 45.2% vs. control 56.1%; relative risk [RR] 0.80; 95% confidence interval [CI] 0.53–1.24) except that women in the treatment group had a significantly lower A1C over time than women in the control group ( p  = 0.04). Nonobese women ( n  = 50) treated for GDM experienced a 50% reduction in GDM compared with controls (29.6 vs. 60.9%; RR 0.49; 95% CI 0.25–0.95). Conclusion  Early treatment for women with a first-trimester A1C of 5.7 to 6.4% did not significantly reduce the risk of GDM except in nonobese women.