Mild gestational diabetes in pregnancy and the adipoinsular axis in babies born to mothers in the ACHOIS randomised controlled trial

95 women with mild GDM on oral glucose tolerance testing (OGTT) at one tertiary level maternity hospital who had been recruited to the ACHOIS trial at one of the collaborating hospitals and randomised to either Treatment (n = 46) or Routine Care (n = 49) and Control women with a normal OGTT (n = 133) were included in the study. Women with mild GDM (treatment or routine care group) and OGTT normal women received routine pregnancy care. In addition, women with treated mild GDM received dietary advice, blood glucose monitoring and insulin if necessary.The primary outcome measures were cord blood concentrations of glucose, insulin, adiponectin and leptin.Cord plasma glucose was higher in women receiving routine care compared with control, but was normalized by treatment for mild GDM (p = 0.01). Cord serum insulin and insulin to glucose ratio were similar between the three groups. Leptin concentration in cord serum was lower in GDM treated women compared with routine care (p = 0.02) and not different to control (p = 0.11). Adiponectin was lower in both mild GDM groups compared with control (Treatment p = 0.02 and Routine Care p = 0.07), while the adiponectin to leptin ratio was lower for women receiving routine care compared with treatment (p = 0.08) and control (p = 0.05).Treatment of women with mild GDM using diet, blood glucose monitoring and insulin if necessary, influences the altered fetal adipoinsular axis characteristic of mild GDM in pregnancy.Mild gestational diabetes is a common complication of pregnancy, affecting up to 9% of pregnant women [1]. Significant maternal, fetal and neonatal morbidities are associated with disturbances of glucose homeostasis in pregnancy. Gestational diabetes mellitus (GDM) increases the risk of macrosomia and associated birth injuries, such as shoulder dystocia, bone fractures and nerve palsies. Treatment of mild GDM is known to reduce these adverse perinatal outcomes [2]. Longer-term adverse health effects on offspring born to mo