Predictors and Outcomes in Gestational Diabetes Requiring Insulin Therapy

Abstract

Objective: To evaluate risk factors that predict Insulin requirements and outcomes in women with gestational diabetes in a resource-limited country. Study Design: Retrospective longitudinal study. Place and Duration of Study: Department of Gynaecology and Obstetrics, Combined Military Hospital, Mangla Pakistan, from Jan to Dec 2019. Methodology: Our study included 100 pregnant women with gestational diabetes over a period of one year. The primary outcome was to calculate the frequency of gestational diabetes and the correlation between maternal age and parity with subdermal Insulin therapy in a peripheral (Class C) hospital. The secondary outcomes of this study included mode of delivery and neonatal birth weight. Results: Out of 1509 deliveries, our study included 100 pregnant women (6.62%). Sixty-two (62%) required Insulin to control hyperglycemia in addition to oral Metformin; 36% required oral Metformin alone. Maternal age (p=0.078), presence of co-morbidity (p=0.260), and parity (p=0.242) did not predict Insulin requirement. A caesarean section (69%) was the most common mode of delivery. Insulin requirements to control hyperglycemia didn’t correlate with mode of delivery (p=0.825). The neonatal birth weight was 3.30±0.33 kg in patients requiring Insulin versus 3.26±0.25 kg in other treatments (p=0.86). There was one intrauterine death. Conclusion: The frequency of gestational diabetes was 6.62%. Maternal age, parity, and the presence of maternal co-morbidities did not predict Insulin requirements. There was no correlation between Insulin therapy, mode of delivery, or neonatal outcome.

Keywords

• Birth weight, Gestational diabetes, Insulin requirement, Maternal age, Mode of delivery, Parity