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Departments of Obstetrics and Medicine, Section on Preventive Medicine and Epidemiology, Boston University and Boston City Hospital, Boston, Massachusetts.
The outcome of pregnancy in control and treated gestational diabetics was not significantly different. The decreased loss rate among the insulin- and diet-treated gestational diabetics, however, did become significant when the data were reanalyzed with consideration of two important influencing variables. The high-risk group of gestational diabetics aged 25 years and older who received insulin therapy before the 32nd week of gestation had fewer fetal losses. Documentation of the critical role played by both maternal age and the gestational age at which insulin therapy is commenced now makes the institution of a conclusive prospective study feasible. The adequately established hypothesis that insulin management of gestational diabetics favorably affects the outcome of their pregnancies can then be finally resolved.
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