Recent Diabetes articles in the Big 4

EDITORIAL: Gestational Diabetes -- Setting Limits, Exploring Treatments
via New England Journal of Medicine by Ecker, J. L., Greene, M. F. on 5/7/08
Pregnancy is associated with relative carbohydrate intolerance and insulin resistance. Gestational diabetes mellitus (carbohydrate intolerance first diagnosed during pregnancy) has long been recognized as a risk factor for a number ...

ORIGINAL ARTICLE: Metformin versus Insulin for the Treatment of Gestational Diabetes
via New England Journal of Medicine by Rowan, J. A., Hague, W. M., Gao, W., Battin, M. R., Moore, M. P., the MiG Trial Investigators on 5/7/08
This open-label trial compared insulin with metformin (with supplemental insulin if required) for the treatment of gestational diabetes mellitus. The rates of neonatal complications were similar in the two groups, and more women in the metformin group than in the insulin group reported that they would choose their assigned treatment again. These results provide support for the use of metformin as initial treatment for gestational diabetes in women who require pharmacologic therapy.

ORIGINAL ARTICLE: Hyperglycemia and Adverse Pregnancy Outcomes
via New England Journal of Medicine by The HAPO Study Cooperative Research Group on 5/7/08
In this large, multinational study, glucose levels that were increased during pregnancy but were below levels diagnostic of diabetes were significantly associated with increased risks of birth weight above the 90th percentile and C-peptide levels above the 90th percentile, as well as with other adverse pregnancy outcomes. These results indicate the need to reconsider current thresholds for diagnosing and treating hyperglycemia during pregnancy.

CLINICAL CROSSROADS: A 40-Year-Old Woman With Diabetes Contemplating Pregnancy After Gastric Bypass Surgery
via JAMA current issue by Burns, R. B. on 5/6/08