Glycaemic control in labour with diabetes (GILD Trial)

  • Research type

    Research Study

  • Full title

    The clinical and cost effectiveness of tight versus more relaxed glucose control around the time of birth in pregnancies complicated by gestational diabetes (GILD)

  • IRAS ID

    333765

  • Contact name

    Kate Walker

  • Contact email

    Kate.Walker@nottingham.ac.uk

  • Sponsor organisation

    The University of Nottingham

  • Duration of Study in the UK

    2 years, 0 months, 31 days

  • Research summary

    Diabetes in pregnancy affects 9 women/birthing people in 100. 8 in 10 have gestational diabetes (GDM), which develops in pregnancy and then disappears. GDM women/birthing people are closely monitored and treated in labour or before a caesarean birth to keep their blood sugars at a safe level for them and their baby. Many women/birthing people find monitoring during labour intrusive. Recent research suggests tight monitoring of blood sugars may not be as important for preventing problems in the baby as once thought. We will compare tight control of blood sugars with a more relaxed approach to see if this impacts the woman/birthing person's labour, birth outcomes and experience, and their baby’s blood sugar levels and health.
    We will include 1630 women/birthing people. Half will have their blood sugars monitored tightly during labour. This means finger prick blood glucose testing will occur hourly, with the aim to keep blood sugar levels between 4-7mmol/L. The other half will have their blood sugars monitored in a more relaxed approach (tested every 2-4 hours with a blood sugar aim of 4-10mmol/L). When blood sugars go out of the specified range, women will be treated with insulin, as they would as part of usual care.
    We will compare the rates of low blood sugars and neonatal unit admissions in babies born to see if ‘more relaxed’ control is as good as ‘tight’ control. We will ask women/birthing people what they think about the blood sugar monitoring and their birth experience. We will compare costs and outcomes of the two strategies used in the study to see if one is better value for money.
    South Asian women/birthing people are twice as likely to develop GDM as white European women/birthing people. We will work with our collaborators to help us increase recruitment of South Asian women/birthing people to this study.

  • REC name

    East of England - Cambridge East Research Ethics Committee

  • REC reference

    25/EE/0116

  • Date of REC Opinion

    17 Jun 2025

  • REC opinion

    Further Information Favourable Opinion