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Systematic review with meta-analysis
Treating mild gestational diabetes yields benefits with little or no evidence of harms
  1. Donald Coustan
  1. Department of Obstetrics and Gynecology, Women & Infants Hospital of Rhode Island, Providence, Rhode Island, USA
  1. Correspondence to: Donald Coustan, Department of Obstetrics and Gynecology, Women & Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI 028905, USA; donald_coustan{at}brown.edu

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The screening, diagnosis and treatment of gestational diabetes have been a contentious topic for at least 25 years, when Hunter and Keirse1 concluded, “Except for research purposes, all forms of glucose tolerance testing should be stopped.” This judgement was based on a lack of firm epidemiological evidence for benefit to the population, and the need for “population-based research to establish the true risk of sub-diabetic degrees of hyperglycaemia during pregnancy,” which should then be followed by ‘rigorous, randomized trials’ of therapy. In recent years the HAPO study established a continuum of adverse pregnancy outcomes associated with increasing maternal …

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