Predictors of Insulin Therapy Requirement in Gestational Diabetes:A Cohort Study

Abstract

Managing Gestational Diabetes Mellitus (GDM) typically involves a combination of dietary control and/or Antenatal Insulin Therapy (AIT). The aim ofthis study was to evaluate the efficiency of diverse maternal characteristics and biological indicators identified during GDM diagnosis in anticipating therequirement for AIT to achieve glucose targets.
It is a retrospective longitudinal study that included women diagnosed with GDM. A cohort of 380 women was examined, and a range of demographic and medical variables were evaluated.
The average age in our patient group was 34 ± 5 years, ranging from 20 to 46 years. Among them, 73% needed AIT, while 100 patients achieved glycemic goals solely through Medical Nutrition Therapy (MNT). Notably, those requiring insulin had prior history of obesity (24%), gestational diabetes (12%), and macrosomia (18%) (p=10-3). The average hemoglobin level was 12.4 g/dl, and none of our patients were anemic. Patients meeting glycemic targets via MNT had higher total carbohydrate intake upon GDM diagnosis (p=0.02). Those necessitating AIT were diagnosed at an average gestational age (GA) of 24±6 weeks, significantly earlier than the 25±6 weeks observed in patients following MNT (p < 10-3).
Recognizing the diverse spectrum of glucose intolerance severity among women with GDM necessitates a stratified classification for management strategies. Notably, a higher HbA1C at diagnosis signals the potential need for intensified monitoring by specialized healthcare providers.