Predictors for antenatal insulin requirement in gestational diabetes.
The purpose of this study was to identify pre-gestational and gestational factors predicting subsequent insulin requirement in patients with gestational diabetes mellitus (GDM). Maternal parameters were compared between mothers achieving glycemic control with or without the addition of antenatal insulin therapy (AIT). Insulin was required only in 8/83 (10%) patients for glycemic control. Those who needed insulin had a stronger family history of diabetes and higher first hour plasma glucose along with multiple (>1) abnormal values during oral glucose tolerance test (OGTT) in univariate analysis (p < 0.05). The first hour plasma glucose value of ≥ 9.72 mmol/l predicted requirement of AIT in GDM mothers with a sensitivity of 100% and specificity of 73%. However, only positive family history of diabetes mellitus among first degree relatives and multiple abnormal values in OGTT were independent predictors for antenatal insulin requirement in regression analysis.
Department of Obstetrics & Gynecology, All India Institute of Medical Sciences , Raipur, Chhattisgarh , India .
Subarna
S
Mitra
Prasanta Kumar
PK
Nayak
Jayaprakash
J
Sahoo
Agnes
A
Mathew
Alaganandam
A
Padma
Sadishkumar
S
Kamalanathan
Sarita
S
Agrawal
D000328:Adult; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D005192:Family Health; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D011247:Pregnancy; D017584:Reproductive History; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055815:Young Adult
D007328:Insulin
Body mass index; gestational diabetes; insulin