Factors in Gestational Diabetes Mellitus Predicting the Needs for Insulin Therapy

Ya, Zhang; Shao, Jiashen; Li, Feifei; Xu, Xiao

doi:10.1155/2016/4858976

Cited by 24 publications

(24 citation statements)

References 18 publications

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“…In the first study, logistic regression analysis showed that gestational weeks at GDM diagnosis, plasma glucose levels in a 75‐g OGTT at 1 h and HbA1c were significant predictors for insulin therapy. Similar to the present results , other studies showed that plasma glucose levels in a 75‐g OGTT at 1 h and HbA1c were associated with the need for insulin therapy. In particular, Watanabe et al .…”

Section: Discussionsupporting

confidence: 91%

One‐hour oral glucose tolerance test plasma glucose at gestational diabetes diagnosis is a common predictor of the need for insulin therapy in pregnancy and postpartum impaired glucose tolerance

Nishikawa

Ono

Hashimoto

et al. 2018

J of Diabetes Invest

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Aims/IntroductionGestational diabetes mellitus (GDM) is a risk for adverse perinatal outcomes, and patients with a history of GDM have an increased risk of impaired glucose tolerance (IGT). Here, we carried out two non‐interventional and retrospective studies of GDM patients in Japan.Materials and MethodsIn the first study, we enrolled 529 GDM patients and assessed predictors of the need for insulin therapy. In the second study, we enrolled 185 patients from the first study, and assessed predictors of postpartum IGT.ResultsIn the first study, gestational weeks at GDM diagnosis and history of pregnancy were significantly lower, and pregestational body mass index, family history of diabetes mellitus, 1‐ and 2‐h glucose levels in a 75‐g oral glucose tolerance test (OGTT), the number of abnormal values in a 75‐g OGTT, and glycated hemoglobin were significantly higher in participants receiving insulin therapy. In the second study, 1‐ and 2‐h glucose levels in a 75‐g OGTT, the number of abnormal values in a 75‐g OGTT, glycated hemoglobin, and ketone bodies in a urine test were significantly higher in participants with OGT. Logistic regression analysis showed that gestational weeks at GDM diagnosis, 1‐h glucose levels in a 75‐g OGTT and glycated hemoglobin were significant predictors of the need for insulin therapy, and 1‐h glucose levels in a 75‐g OGTT at diagnosis and ketone bodies in a urine test were significant predictors for postpartum IGT.ConclusionsAntepartum 1‐h glucose levels in a 75‐g OGTT was a predictor of the need for insulin therapy in pregnancy and postpartum IGT.

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Section: Discussionsupporting

confidence: 91%

One‐hour oral glucose tolerance test plasma glucose at gestational diabetes diagnosis is a common predictor of the need for insulin therapy in pregnancy and postpartum impaired glucose tolerance

Nishikawa

Ono

Hashimoto

et al. 2018

J of Diabetes Invest

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“…Moreover, elevated fasting glucose level at the time of OGTT had been a strong factor associated with insulin therapy in pregnancy. Different cut-off values based on applied criteria for diagnosis of GDM were reported for this association [45–47]. Another report by Langer showed that fasting glucose > 105 mg/dL was associated with fetal macrosomia, hypoglycemia in newborn infants, cesarean delivery, and a need for insulin therapy [48].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Contributing Factors of Persistent Hyperglycemia at 6–12 Weeks Postpartum in Iranian Women with Gestational Diabetes: Results from LAGA Cohort Study

Nouhjah

Shahbazian

et al. 2017

Journal of Diabetes Research

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Background. A history of gestational diabetes is an important predictor of many metabolic disturbances later in life. Method. Life after gestational diabetes Ahvaz Study (LAGAs) is an ongoing population-based cohort study. Up to February 2016, 176 women with gestational diabetes underwent a 75 g oral glucose tolerance test (OGTT) at 6–12 weeks postpartum in Ahvaz (southwestern of Iran). Gestational diabetes was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and the American Diabetes Association (ADA) criteria applied for diagnosis of postpartum prediabetes and diabetes. Univariate and multivariate regression analysis were done. Results. Overall incidence of early postpartum glucose intolerance was 22.2% (95% CI, 16.3–29.0), 17.6% prediabetes (95% CI, 12.3–24.1) and 4.5% diabetes (95% CI, 2.0–8.8%). Independent risk factors for glucose intolerance were FPG ≥ 100 at the time of OGTT (OR 3.86; 95% CI; 1.60–9.32), earlier diagnosis of GDM (OR 0.92; 95% CI; 0.88–0.97), systolic blood pressure (OR 1.02; 95% CI; 1.002–1.04), and insulin or metformin therapy (OR 3.14; 95% CI; 1.20–8.21). Conclusion. Results determined a relatively high rate of glucose intolerance at 6–12 weeks after GDM pregnancy. Early postpartum screening of type 2 diabetes is needed particularly in women at high risk of type 2 diabetes.

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“…[2] However, the proportion may be higher among women with GDM because of the effects of nutritional therapy and exercise, which are the main methods used to control blood glucose in GDM. [8] The prevalence of GDM in China has recently increased to 14.7–20.9%, [9] which represents epidemic proportions. Therefore, it is essential to understand whether abnormal GWG is associated with pregnancy outcomes in women with GDM.…”

Section: Introductionmentioning

confidence: 99%

Gestational diabetes

Gou

Guan

et al. 2019

Chinese Medical Journal

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Background:Weight gain during pregnancy reflects the mother's nutritional status. However, it may be affected by nutritional therapy and exercise interventions used to control blood sugar in gestational diabetes mellitus (GDM). This study aimed to evaluate weight gain during gestation and pregnancy outcomes among women with GDM.Methods:A retrospective study involving 1523 women with GDM was conducted between July 2013 and July 2016. Demographic data, gestational weight gain (GWG), blood glucose, glycated-hemoglobin level, and maternal and fetal outcomes were extracted from medical records. Relationships between GWG and pregnancy outcomes were investigated using multivariate logistic regression.Results:In total, 451 (29.6%) women showed insufficient GWG and 484 (31.8%) showed excessive GWG. Excessive GWG was independently associated with macrosomia (adjusted odds ratio [aOR] 2.20, 95% confidence interval [CI] 1.50–3.52, P < 0.001), large for gestational age (aOR 2.06, 95% CI 1.44–2.93, P < 0.001), small for gestational age (aOR 0.49, 95% CI 0.25–0.97, P = 0.040), neonatal hypoglycemia (aOR 3.80, 95% CI 1.20–12.00, P = 0.023), preterm birth (aOR 0.45, 95% CI 0.21–0.96, P = 0.040), and cesarean delivery (aOR 1.45, 95% CI 1.13–1.87, P = 0.004). Insufficient GWG increased the incidence of preterm birth (aOR 3.53, 95% CI 1.96–6.37, P < 0.001).Conclusions:Both excessive and insufficient weight gain require attention in women with GDM. Nutritional therapy and exercise interventions to control blood glucose should also be used to control reasonable weight gain during pregnancy to decrease adverse pregnancy outcomes.

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Factors in Gestational Diabetes Mellitus Predicting the Needs for Insulin Therapy

Cited by 24 publications

References 18 publications

One‐hour oral glucose tolerance test plasma glucose at gestational diabetes diagnosis is a common predictor of the need for insulin therapy in pregnancy and postpartum impaired glucose tolerance

One‐hour oral glucose tolerance test plasma glucose at gestational diabetes diagnosis is a common predictor of the need for insulin therapy in pregnancy and postpartum impaired glucose tolerance

Incidence and Contributing Factors of Persistent Hyperglycemia at 6–12 Weeks Postpartum in Iranian Women with Gestational Diabetes: Results from LAGA Cohort Study

Gestational diabetes

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