Early Gestational Diabetes Mellitus

NCT ID: NCT04451915

Last Updated: 2023-01-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

2010 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-30

Study Completion Date

2023-12-31

Brief Summary

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In 2010, the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) panel published consensus-based recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Cognizant that milder degrees of hyperglycemia would also be detected by early pregnancy testing, the IADPSG recommended that fasting plasma glucose (FPG) in the range of 5.1-6.9 mmol/l should be considered diagnostic of early Gestational Diabetes Mellitus (GDM) even if the level of proof for this recommendation is very low regarding to prognosis. This threshold was extrapolated from the FPG value used between 24 and 28 weeks.

In France, a FPG is proposed at the first prenatal visit for women with risk factors of GDM. Early GDM is diagnosed if FPG is ≥ 5.1 mmol/l, leading to an intensive metabolic management. Data have shown that GDM prevalence increased rapidly from 5.9% in 2009 to 9.3% in 2014. 26.9% of women with hyperglycemia during their pregnancy but without known diabetes are treated before 22 weeks' gestation (WG). More recent data from Italy and China, where IADPSG diagnosis criteria were applied, have strongly challenged this recommendation, and showed that early FPG ≥ 5.1mmo/L is poorly predictive of later GDM. No prior studies have demonstrated benefits to early screening and management. In 2016, the IADPSG members have suggested that the use of the FPG threshold ≥5.1 mmol/l for the identification of GDM in early pregnancy is not justified by current evidence

Detailed Description

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Conditions

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Gestational Diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Early management GDM group

defined as no intervention until GDM screening at 24-28 weeks' gestation. If there is a diagnosis of GDM at 24-28 according to the IADPSG criteria), intensive metabolic treatment until delivery

Group Type EXPERIMENTAL

early management strategy

Intervention Type OTHER

early management of GDM defined as intensive metabolic treatment. Intensive treatment involved the following multidisciplinary approach: lifestyle defined by diet and exercise intervention according to the French guidelines

Late management GDM group

early management of GDM defined as intensive metabolic treatment (diet, physical activity self-blood glucose monitoring according and/or insulin therapy according to the French guidelines). This intensive treatment will begin after the randomization until delivery.

Group Type EXPERIMENTAL

late management strategy

Intervention Type OTHER

late management strategy of GDM defined as no intervention until GDM screening at 24-28 weeks. Between 24-28 weeks gestation, a 75-g OGTT will be done

Interventions

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late management strategy

late management strategy of GDM defined as no intervention until GDM screening at 24-28 weeks. Between 24-28 weeks gestation, a 75-g OGTT will be done

Intervention Type OTHER

early management strategy

early management of GDM defined as intensive metabolic treatment. Intensive treatment involved the following multidisciplinary approach: lifestyle defined by diet and exercise intervention according to the French guidelines

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Pregnant woman
* Singleton pregnancy
* Early GDM defined by a fasting plasma glucose between 5.1 mmol/l and 6.1 mmol/ with at least one risk factor (age ≥35 years and/or BMI ≥ 25 kg/m2 and/or familial history of diabetes and/or personal history of GDM and/or personal history of macrosomia).
* First prenatal visit prior 20 weeks of gestation at the time of randomization.
* Signed informed consent

Exclusion Criteria

Diabetic follow-up started at time of inclusion

* Pre-existing diabetes in pregnancy
* Renal impairment
* Hepatic insufficiency
* History of bariatric surgery
* Long time corticosteroids treatment
* Insufficient understanding
* Language difficulties
* Lack of social Insurance
* Person in emergency situation
* Person under the protection of justice (tutelage/ curatorship)
* Persons deprived of their liberty
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Lille

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anne VAMBERGUE

Role: STUDY_DIRECTOR

University Hospital, Lille

Locations

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CH ARRAS

Arras, , France

Site Status RECRUITING

Hopital Estaing - Chu63 - Clermont Ferrand

Clermont-Ferrand, , France

Site Status RECRUITING

Hop Claude Huriez Chu Lille

Lille, , France

Site Status RECRUITING

Hopital Saint Vincent - Saint Antoine - Lille

Lille, , France

Site Status RECRUITING

Chu Nimes Caremeau - Nimes 9

Nîmes, , France

Site Status RECRUITING

Hopital Haut-Leveque - Chu - Pessac

Pessac, , France

Site Status RECRUITING

Ch Rene Dubos - Pontoise

Pontoise, , France

Site Status RECRUITING

Chu Site Sud (Saint Pierre) - St Pierre

Saint-Pierre, , France

Site Status RECRUITING

Csapa / Hus / Hopital Civil - Strasbourg

Strasbourg, , France

Site Status RECRUITING

Hopital de Rangueil Chu Toulouse

Toulouse, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Anne VAMBERGUE, MD,PhD

Role: CONTACT

0320445962

Facility Contacts

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Role: primary

0320445962

Other Identifiers

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2018-A00794-51

Identifier Type: OTHER

Identifier Source: secondary_id

PHRC-17-008

Identifier Type: OTHER

Identifier Source: secondary_id

2017_76

Identifier Type: -

Identifier Source: org_study_id

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