One-hour post-glucola results and pre-pregnancy body mass index are associated with the need for insulin therapy in women with gestational diabetes

J Matern Fetal Neonatal Med. 2011 May;24(5):718-22. doi: 10.3109/14767058.2010.521869. Epub 2010 Oct 12.

Abstract

Objective: The purpose of this study was to analyze the relationship of 1-h post-glucola (PG) screening results and the need for insulin therapy in women with gestational diabetes (GDM).

Methods: The study group was comprised of women with GDM treated at a single institution during calendar years 2000-2004. Women with singleton, term (≥ 37 weeks gestation), liveborn fetuses were included. The association of 1-h PG results and other perinatal risk factors to the need for subsequent insulin therapy was analyzed using multivariable logistic regression models.

Results: Of the 1451 women were included in the analysis, 18.1% required insulin treatment. The mean 1-h PG result was 170.0 ± 26.1 mg/dl (range 140-414 mg/dl). We determined that a 1-h PG ≥ 190 mg/dl (p < 0.0001), an obese body mass index (BMI) (p < 0.0001), an overweight BMI (p = 0.0019), prior GDM (p = 0.0019), and prior macrosomia (p = 0.0210) were each highly associated with the need for subsequent insulin therapy during the pregnancy.

Conclusions: A 1-h PG ≥ 190 mg/dl was strongly associated with the need for insulin therapy in women with GDM. These data may be helpful in counseling and managing women with GDM.

MeSH terms

  • Adolescent
  • Adult
  • Body Mass Index*
  • Carbohydrates*
  • Diabetes, Gestational / diagnosis*
  • Diabetes, Gestational / drug therapy
  • Female
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use*
  • Logistic Models
  • Middle Aged
  • Multivariate Analysis
  • Pregnancy
  • Retrospective Studies
  • Risk Factors
  • Young Adult

Substances

  • Carbohydrates
  • Glucola
  • Hypoglycemic Agents
  • Insulin