title: Risk Factors for the Requirement of Antenatal Insulin Treatment in Gestational Diabetes Mellitus.
abstract: Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM) is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT) are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group;n= 10) and without insulin therapy (Diet group;n= 27). The 1-h and 2-h plasma glucose levels and the number of abnormal values in 75 g OGTT were significantly higher in AIT group compared with Diet group. By logistic regression analysis, plasma glucose level at 1-h was significant predictor for AIT and the odds ratios were 1.115 (1.004-1.239) using forward selection method and 1.192 (1.006-1.413) using backward elimination method. There were no significant differences in obstetrical outcomes and neonatal complications. 1-h plasma glucose levels in 75 g OGTT are useful parameters in predicting the requirement for AIT in GDM. Both maternal and neonatal complications are comparable in GDM patients with and without insulin therapy.
authors.affiliation: Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan; Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo 670-8540, Japan.
authors.forename: Mayu
authors.identifier: 0000-0003-4253-3465
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Katayama
authors.affiliation: Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo 670-8540, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kagawa
authors.affiliation: Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan; Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo 670-8540, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ogawa
authors.affiliation: Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Wada
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D011247:Pregnancy; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin