title: The effects of adjuvant insulin therapy among pregnant women with IGT who failed to achieve the desired glycemia levels by diet and moderate physical activity.
abstract: OBJECTIVE
  Evaluation of adjuvant insulin therapy effects on glycemic control, perinatal outcome and postpuerperal glucose tolerance in impaired glucose tolerance (IGT) pregnant women who failed to achieve desired glycemic control by dietary regime.
  
  
  METHODS
  A total of 280 participants were classified in two groups: Group A patients continued with dietary regime and Group B patients were treated with adjuvant insulin therapy. Glycemic control was assessed by laboratory and ultrasonograph means. Pregnancy outcomes were evaluated by prevalence of pregnancy induced hypertension (PIH), high birth weight, neonatal hypoglycemia and caesarean section rates. Postpuerperal glucose tolerance was assessed by oral glucose tolerance test (oGTT).
  
  
  RESULTS
  All laboratory and ultrasound indicators of glycemic control had significantly lower values in Group B. Group A women were more likely to develop the EPH (Edema, Proteinuria, Hypertension) syndrome, 20% versus 7.86% (p = 0.003). High birth weight occurred more frequently in Group A, but the difference was not significant (p = 0.197). Higher rate of caesarean delivery was in Group A than in Group B, 16.43% versus 26.43% (p = 0.041). The difference in neonatal hypoglycemia was not significant (p = 0.478). Pathological oGTT results were observed in 73 Group A patients and in 15 Group B patients.
  
  
  CONCLUSIONS
  Lower caesarean section rates and the EPH syndrome incidence are the benefits of adjuvant insulin therapy in IGT patients.
authors.affiliation: Institute of Gynecology and Obstetrics, Clinical Centre of Serbia, Clinical Hospital Centre, Zemun, Belgrade, Serbia.
authors.forename: Miroslava
authors.initials: M
authors.lastname: Gojnic
authors.forename: Milan
authors.initials: M
authors.lastname: Perovic
authors.forename: Miroslava
authors.initials: M
authors.lastname: Pervulov
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Ljubic
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D016640:Diabetes, Gestational; D004035:Diet Therapy; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005081:Exercise Therapy; D005260:Female; D044882:Glucose Metabolism Disorders / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D007336:Insulin, Isophane / Q000627:therapeutic use*; D061386:Insulin, Regular, Human / Q000627:therapeutic use*; D061389:Insulin, Regular, Pork; D000068880:Isophane Insulin, Human; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D011256:Pregnancy Outcome; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D061386:Insulin, Regular, Human; D061389:Insulin, Regular, Pork; D000068880:Isophane Insulin, Human; D007336:Insulin, Isophane; C000006:insulin, neutral