Endocrine Abstracts

Aim of the study

To identify the factors predicting insulin need in women with Gestational Diabetes Mellitus (GDM).

Methods

It was a retrospective study conducted in the National Institute of Nutrition between January 2018 and January 2019. Pregnant women referred for the management of GDM were included (n = 1000).GDM was defined according to the World Health Organisation as a glucose intolerance of variable severity with onset or first recognition during pregnancy. ANOVA and Pearson’s chi-square tests were performed to compare clinical and biological characteristics of women with insulin therapy (IT) and those with nutrition therapy (NT).

Results

IT was initiated for 291 patients while the rest were maintained on NT (70.90%). Older women were significantly more likely to need IT (33.1±5.3 vs 32.6±5.1 years; P = 0.028).We found a significant association between educational attainment and the need for IT (P = 0.004). Family history of type 2 diabetes as well as personal history of GDM or foetal macrosomia increases the need for IT (P = 0.001, P = 0.002 and P = 0.025 respectively).Women with IT had more risk factors of GDM (P <0.001). All women having five risk factors had required IT.NT’s failure was higher in obese women (36.60% vs 25.30%; P = 0.011). For women with IT, GDM was diagnosed at an earlier term (23.33 ± 6.8 vs 24.52 ± 7.1 weeks of gestation; P = 0.017). Fasting plasma glucose was higher in women with IT (5.25±1.07 mmol/l vs 4.67±0.60 mmol/l; P <0.001) as was Glycated hemoglobin (5.48±0.52% vs 5.23±0.38%; P <0.001).

Conclusion

Factors predicting insulin need may allow physicians to establish a concise scoring method for early identification of those women.