Endocrine Abstracts

JOINT632

Background: Gestational diabetes mellitus (GDM) is associated with adverse maternal and neonatal outcomes. There is currently no uniform guidelines for the management of GDM and the observation period when to progress from non-pharmacologic to pharmacologic treatment varies. This will lead to a delay in initiation of a definitive therapy which will probably increase risk of complication from GDM. This study aims to investigate the association between fasting blood glucose at diagnosis of GDM and glycemic control based on self-monitoring blood glucose (SMBG) after 2 weeks of non-pharmacologic therapy.

Methodology: We conducted a single-center observational retrospective cohort study of patients with GDM at Ospital ng Makati (OsMak) from 2013-2023. Included were patients with fasting blood sugar (FBS) values of 92-125 mg/dL who had their prenatal visits and delivery at OsMak. Medical records were reviewed and the following data were collected: current age, weight, height, BMI on initial prenatal visit, co-morbidities such as hypertension, diabetes mellitus, autoimmune diseases (SLE, APAS) and obstetric history. FBS at initial visit or at 24-28 weeks AOG and SMBG values were recorded. Subsequent mode of therapy, either non-pharmacologic or pharmacologic, was assessed.

Results: We included a total of 112 patients with GDM in the study. 50% (95% CI: 40. 4-59. 6%) achieved glycemic control through non-pharmacologic therapy. There was no significant difference between the two groups (glycemic control achieved vs not achieved) in any of the variables except for FBS at the time of GDM diagnosis. Median FBS was significantly higher in patients who did not achieve glycemic control than those who did. Patients with FBS at GDM diagnosis of >99 mg/dl had about 23 times higher odds of non-achievement of glycemic control than those with FBS of ≤99 mg/dl.

Conclusion: The result of this study demonstrates that FBS at GDM diagnosis was significantly associated with glycemic control and showed excellent discriminative ability with a sensitivity of 87. 50% and specificity of 76. 79 %. Patients with FBS at GDM diagnosis of >99 mg/dl had about 23 times higher odds of non-achievement of glycemic control than those with FBS of ≤99 mg/dl.

Keywords: “gestational diabetes mellitus”, “fasting blood sugar”, “glycemic control”