Identifying the Risk Group for Insulin Therapy in Patients with Gestational Diabetes

Le résumé fourni par la source

Aim: This study aims to determine the predictors of antenatal insulin therapy (AIT) in patients with gestational diabetes mellitus (GDM) who applied to the outpatient endocrine clinic of a tertiary hospital. Material and Methods: The study included 619 patients with GDM.Oral glucose tolerance test (OGTT), HbA1c (%), lipid levels, and other biochemical measurements of two groups (patients with or without insulin use) were compared with Mann-Whitney U or Student t-test. Demographic characteristics, obesity, and diet adherence were compared with the Chi-Square test. OGTT-75 measurements between the three insulin groups (basal, bolus or both uses) were compared with ANOVA. Results: In this study, 27.0% of the GDM patients needed insulin therapy. The insulin group had a significantly higher rate of obese, morbidly obese, and poor diet adherence patients than the MNT group and had significantly higher values measured in the 75-g OGTT (OGTT-75) for 0-h glucose, 2-h glucose, HbA1C (%), and triglyceride. In OGTT-75, all three measurement values (0-h, 1-h, 2-h glucose) above the cut-off were associated with insulin requirement. In OGTT-75, 2-h glucose value > 151.5 mg/dL (68.4% sensitivity and 60.0% specificity) predicted general need for insulin, and 0-h glucose value > 95.0 mg/dL (72.0% sensitivity and 69.0% specificity) predicted the need for basal AIT. Conclusion: We suggest identifying the risky group for insulin therapy at the time of diagnosis in GDM. Closer follow-up is required for the patients found to be in the risk group for insulin therapy.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.