Predictors of treatment requirements in women with gestational diabetes : a retrospective analysis

ORCID
0000-0002-2903-391X
Affiliation
Department of Obstetrics, University Hospital Jena, 07747 Jena, Germany; friederike.weschenfelder@med.uni-jena.de (F.W.); ekkehard.schleussner@med.uni-jena.de (E.S.)
Weschenfelder, Friederike;
GND
1244964654
Affiliation
Unit Neonatology, Department of Paediatrics, University Hospital Jena, 07747 Jena, Germany; karolin.lohse@med.uni-jena.de
Lohse, Karolin;
GND
1216191093
Affiliation
Institute of Medical Statistics and Computer Science, University Hospital Jena, Friedrich Schiller University, 07747 Jena, Germany; thomas.lehmann@med.uni-jena.de
Lehmann, Thomas;
GND
123039762
Affiliation
Department of Obstetrics, University Hospital Jena, 07747 Jena, Germany; friederike.weschenfelder@med.uni-jena.de (F.W.); ekkehard.schleussner@med.uni-jena.de (E.S.)
Schleußner, Ekkehard;
GND
11819187X
ORCID
0000-0003-3553-4056
Affiliation
Department of Obstetrics, University Hospital Jena, 07747 Jena, Germany; friederike.weschenfelder@med.uni-jena.de (F.W.); ekkehard.schleussner@med.uni-jena.de (E.S.)
Groten, Tanja

The diagnosis of gestational diabetes is usually very stressful for pregnant women, especially because they fear that insulin treatment may become necessary. Knowledge about personal risk factors predicting the probability of insulin treatment could therefore help to improve acceptance of the diagnosis and therapy adherence. The aim of this study was to find potential risk factors for insulin dependency and treatment requirements using information available at the time of diagnosis of gestational diabetes during pregnancy. We included 454 singleton pregnancies diagnosed ≥24 weeks of gestation. Multivariate regression analysis was used to evaluate independent associations of metabolic, anthropometric and fetal ultrasound parameters with the general need for insulin treatment and further stratified treatment options: diet ( n = 275), bolus insulin only ( n = 45), basal insulin only ( n = 73) and multiple daily injections ( n = 61). Receiver operator characteristics and cut-off values for independent variables were generated. Treatment groups differed significantly concerning pre-pregnancy weight and BMI as well as fasting glucose and 1 h glucose test values. Significant cut-offs for insulin dependency were HbA1c level of 5.4%, FPG of 5.5 mmol/L and 1 h glucose of 10.6 mmol/L. At time of diagnosis, certain patient characteristics and measurements can help to predict treatment necessities and therefore improve individualized counselling.

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This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.