Glycaemic control in labour with diabetes (GILD)
Diabetes in pregnancy affects at least 5% of pregnant women. For most women this is gestational diabetes (GDM) (87.5%), but 12.5% women have pre-existing diabetes.
There is evidence that ‘tight’ glycaemic control in pregnancy reduces the risk of adverse outcomes for the mother and the baby. Traditionally ‘tight’ glucose control (target 4-7 mmol/L) is recommended in labour. Treatment with intravenous insulin may be needed during labour to maintain ‘tight’ control, however, this increases the risk of maternal hypoglycaemia in labour, which carries a risk to the mother.
Hourly intrapartum testing is also intrusive for women and time consuming for health care practitioners. Conversely, accepting more permissive glucose levels in the mother may be detrimental to the baby. Maternal hyperglycaemia results in increased fetal insulin production because of excess placental transfer of glucose and can lead to neonatal hypoglycaemia.
This study will assess whether it is feasible to run a trial to assess the clinical and cost-effectiveness of permissive versus intensive intrapartum glycaemic control in women with pregnancies complicated by diabetes.
Oxford project lead:
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Stavros Petrou
Academic Research Lead in Health Economics
Collaborators:
Nia Jones, University of Nottingham
Dates:
February 2021 – January 2023
Funder:
National Institute for Health Research (Health Technology Assessment Programme)
Our team
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Stavros Petrou
Academic Research Lead in Health Economics
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Lucy Abel
Health Economist, DPhil student
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Felix Achana
Senior Researcher in Health Economics
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Laura Armitage
Wellcome Trust Doctoral Research Fellow
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Corneliu Bolbocean
Senior Researcher in Health Economics
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Laia Bosque Mercader
Research Fellow in Health Economics
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John Buckell
Researcher
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Padraig Dixon
Senior Researcher in Health Economics
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Patrick Fahr
Quantitative Researcher
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Carmen Fierro Martinez
NIHR Pre-Doctoral Fellow
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Nadeem Hussein
NIHR Pre-Doctoral Fellow
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Joseph Kwon
Researcher in Health Economics
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Sungwook Kim
Senior researcher in Health Economics
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Joan Madia
Researcher in Health Economics
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Joaquim Vidiella Martin
Researcher in Economics
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Catia Nicodemo
Senior Research Fellow in Health Economics
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Olu Onyimadu
Health Economist, DPhil Candidate
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May Png
Senior Researcher in Health Economics
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Stuart Redding
Project Lead, Centre for Health Service Economics & Organisation
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Elizabeth-Ann Schroeder
Senior Researcher in Health Economics
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Raphael Wittenberg
Deputy Director, Centre for Health Service Economics and Organisation
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Yaling Yang
Senior Researcher in Health Economics