Risk Factors for Insulin Therapy in Gestational Diabetes Mellitus

Objectives: To determine the factors associated with insulin requirement in patients with gestational diabetes mellitus (GDM) and compare the obstetrics outcomes between those who required insulin therapy and who did not. Materials and Methods: A case-control study was conducted, including 100 GDM w...

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Main Author: Kaewsrinual S.
Other Authors: Mahidol University
Format: Article
Published: 2023
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/86704
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spelling th-mahidol.867042023-06-19T01:07:59Z Risk Factors for Insulin Therapy in Gestational Diabetes Mellitus Kaewsrinual S. Mahidol University Medicine Objectives: To determine the factors associated with insulin requirement in patients with gestational diabetes mellitus (GDM) and compare the obstetrics outcomes between those who required insulin therapy and who did not. Materials and Methods: A case-control study was conducted, including 100 GDM women who required insulin therapy as cases and 400 GDM women who did not require insulin therapy as controls. Data on baseline and obstetric characteristics, antenatal care, GDM risks, screening and diagnostic test results, labor and delivery, and obstetrics outcomes were reviewed from the medical records. Results: Cases were significantly more likely to be nulliparous, overweight or obese, have DM in family, have had prior GDM, had higher number of GDM risks than controls. Compared with controls, cases had significantly higher plasma glucose level at fasting, 1, and 2 hours, but not at 3 hours after glucose loading and higher rate of abnormal fasting plasma glucose values and higher number of abnormal OGTT values. Logistic regression analysis showed that independent associated factors for insulin requirement were fasting plasma glucose (FPG) at OGTT > 95 mg/dL (adjusted odds ratio (OR) 20.8, 95% confidence interval (CI) 11.4-37.9), overweight or obesity (adjusted OR 1.9, 95%CI 1.1-3.5) and family history of DM (adjusted OR 2.2, 95%CI 1.2-3.9). While other pregnancy outcomes were comparable between the 2 groups, infants of cases were significantly more likely to have neonatal hypoglycemia and need for phototherapy. Conclusion: Independent associated risks for insulin therapy in GDM women included FPG of > 95 mg/dL at OGTT, overweight or obesity, and family history of DM. 2023-06-18T18:07:59Z 2023-06-18T18:07:59Z 2022-01-01 Article Thai Journal of Obstetrics and Gynaecology Vol.30 No.1 (2022) , 51-59 26730871 08576084 2-s2.0-85122798945 https://repository.li.mahidol.ac.th/handle/123456789/86704 SCOPUS
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Kaewsrinual S.
Risk Factors for Insulin Therapy in Gestational Diabetes Mellitus
description Objectives: To determine the factors associated with insulin requirement in patients with gestational diabetes mellitus (GDM) and compare the obstetrics outcomes between those who required insulin therapy and who did not. Materials and Methods: A case-control study was conducted, including 100 GDM women who required insulin therapy as cases and 400 GDM women who did not require insulin therapy as controls. Data on baseline and obstetric characteristics, antenatal care, GDM risks, screening and diagnostic test results, labor and delivery, and obstetrics outcomes were reviewed from the medical records. Results: Cases were significantly more likely to be nulliparous, overweight or obese, have DM in family, have had prior GDM, had higher number of GDM risks than controls. Compared with controls, cases had significantly higher plasma glucose level at fasting, 1, and 2 hours, but not at 3 hours after glucose loading and higher rate of abnormal fasting plasma glucose values and higher number of abnormal OGTT values. Logistic regression analysis showed that independent associated factors for insulin requirement were fasting plasma glucose (FPG) at OGTT > 95 mg/dL (adjusted odds ratio (OR) 20.8, 95% confidence interval (CI) 11.4-37.9), overweight or obesity (adjusted OR 1.9, 95%CI 1.1-3.5) and family history of DM (adjusted OR 2.2, 95%CI 1.2-3.9). While other pregnancy outcomes were comparable between the 2 groups, infants of cases were significantly more likely to have neonatal hypoglycemia and need for phototherapy. Conclusion: Independent associated risks for insulin therapy in GDM women included FPG of > 95 mg/dL at OGTT, overweight or obesity, and family history of DM.
author2 Mahidol University
author_facet Mahidol University
Kaewsrinual S.
format Article
author Kaewsrinual S.
author_sort Kaewsrinual S.
title Risk Factors for Insulin Therapy in Gestational Diabetes Mellitus
title_short Risk Factors for Insulin Therapy in Gestational Diabetes Mellitus
title_full Risk Factors for Insulin Therapy in Gestational Diabetes Mellitus
title_fullStr Risk Factors for Insulin Therapy in Gestational Diabetes Mellitus
title_full_unstemmed Risk Factors for Insulin Therapy in Gestational Diabetes Mellitus
title_sort risk factors for insulin therapy in gestational diabetes mellitus
publishDate 2023
url https://repository.li.mahidol.ac.th/handle/123456789/86704
_version_ 1781416774420398080