Predictive Risk Factors in the Treatment of Gestational Diabetes Mellitus.
OBJECTIVE
This study aims to investigate predictive risk factors in the treatment of gestational diabetes mellitus (GDM).


METHODS
A total of 256 pregnant women who underwent 75 g oral glucose tolerance test (OGTT) during 24-28 weeks of pregnancy were included according to the World Health Organization criteria. Demographic characteristics of the patients, including age, parity, family history of diabetes, body weight before pregnancy, and body weight at the diagnosis of GDM, were recorded. Fasting insulin and hemoglobin A1c (HbA1c) values at the time of diagnosis were evaluated. The patients were divided into two groups: those requiring insulin treatment (insulin group, n = 89) and those receiving diet therapy (diet group, n = 167) during pregnancy according to the American Diabetes Association recommendations.


RESULTS
A total of 34.76% of the pregnant women with GDM required insulin treatment. The mean age of these patients was significantly higher compared to the diet group (34.9 ± 0.6 years vs. 31.9 ± 0.6 years; P = 0.004). Body mass index before pregnancy was also significantly higher in the insulin group than that in the diet group (32 ± 0.9 kg/m(2) vs. 29 ± 0.7 kg/m(2); P = 0.004). Fasting blood glucose (FBG) during OGTT was 105.6 ± 2.1 mg/dL and 96.7 ± 1.1 mg/dL in the insulin group and diet group, respectively (P < 0.001). There was no significant difference in fasting plasma glucose during OGTT between the groups (P = 0.069), while plasma glucose at two hours was 161.1 ± 6.8 mg/dL in the insulin group and 145.1 ± 3.7 mg/dL in the diet group (P = 0.027). At the time of diagnosis, HbA1c values were significantly higher in the insulin group compared to the diet group (5.3 ± 0.1 vs. 4.9 ± 0.1; P = 0.001). There was no significant difference in FBG and homeostasis model assessment-insulin resistance values between the groups (P = 0.908, P = 0.073).


CONCLUSIONS
Our study results suggest that age, family history of diabetes, body weight before pregnancy, FBG, and HbA1c values are predictors for the necessity of insulin treatment.
Department of Obstetrics and Gynecology, Istanbul Medipol University, Istanbul, Turkey.
Lebriz Hale
LH
Aktun
Department of Obstetrics and Gynecology, Istanbul Medipol University, Istanbul, Turkey.
Betul
B
Yorgunlar
Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey.
Nilay
N
Karaca
Department of Obstetrics and Gynecology, Ankara Mevki Military Hospital, Ankara, Turkey.
Yaşam Kemal
YK
Akpak
fasting blood glucose; hemoglobin A1c; obstetric outcome; oral glucose tolerance test; pregnancy