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Risk Factors for Insulin Therapy in Gestational Diabetes Mellitus |
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| รหัสดีโอไอ | |
| Creator | Sriwipa Kaewsrinual |
| Title | Risk Factors for Insulin Therapy in Gestational Diabetes Mellitus |
| Contributor | Dittakarn Borriboonhiransan |
| Publisher | PIMDEE Co., Ltd. |
| Publication Year | 2565 |
| Journal Title | Thai Journal of Obstetrics and Gynaecology |
| Journal Vol. | 30 |
| Journal No. | 1 |
| Page no. | 51-59 |
| Keyword | gestational diabetes mellitus, insulin, risk factor, pregnancy outcomes |
| URL Website | https://tci-thaijo.org/index.php/tjog/index |
| Website title | www.tci-thaijo.org |
| ISSN | 2673-0871 |
| Abstract | Objectives: To determine the factors associated with insulin requirement in patients with gestationaldiabetes mellitus (GDM) and compare the obstetrics outcomes between those who requiredinsulin therapy and who did not.Materials and Methods: A case-control study was conducted, including 100 GDM women whorequired insulin therapy as cases and 400 GDM women who did not require insulin therapy ascontrols. Data on baseline and obstetric characteristics, antenatal care, GDM risks, screeningand diagnostic test results, labor and delivery, and obstetrics outcomes were reviewed from themedical records.Results: Cases were significantly more likely to be nulliparous, overweight or obese, have DM infamily, have had prior GDM, had higher number of GDM risks than controls. Compared withcontrols, cases had significantly higher plasma glucose level at fasting, 1, and 2 hours, but notat 3 hours after glucose loading and higher rate of abnormal fasting plasma glucose valuesand higher number of abnormal OGTT values. Logistic regression analysis showed thatindependent associated factors for insulin requirement were fasting plasma glucose (FPG) atOGTT > 95 mg/dL (adjusted odds ratio (OR) 20.8, 95% confidence interval (CI) 11.4-37.9),overweight or obesity (adjusted OR 1.9, 95%CI 1.1-3.5) and family history of DM (adjusted OR2.2, 95%CI 1.2-3.9). While other pregnancy outcomes were comparable between the 2 groups,infants of cases were significantly more likely to have neonatal hypoglycemia and need forphototherapy.Conclusion: Independent associated risks for insulin therapy in GDM women included FPG of> 95 mg/dL at OGTT, overweight or obesity, and family history of DM. |
