Can we stratify the risk for insulin need in women diagnosed early with gestational diabetes by fasting blood glucose?

Souza, Ana C. R. L. A.; Costa, Rafaela Alkmin da; Paganoti, Cristiane F.; Rodrigues, Agatha Sacramento; Zugaib, Marcelo; Hadar, Eran; Hod, Moshe; Francisco, Rossana Pulcineli Vieira

doi:10.1080/14767058.2018.1424820

Cited by 15 publications

(31 citation statements)

References 11 publications

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“… 20 Factors such as maternal age, FH of diabetes, BMI at GDM diagnosis, and a prior GDM history have also been reported to increase the probability of insulin therapy. 11 , 19 We also observed that women with early-diagnosed GDM were more likely to require insulin intervention, which corroborates the findings of Alunni et al 21 Evidently, it would be imprecise to evaluate the risk of insulin requirement using isolated risk factors while ignoring individual differences. Our study quantified the above factors in a statistical prediction model, which we converted to a clinically usable nomogram that potentially illustrates the extent to which individual risk indicators contribute to the risk of insulin requirement.…”

Section: Discussionsupporting

confidence: 87%

“…A prediction model based on maternal age, pre-pregnancy BMI, FBG value, prior GDM, and FH of diabetes was developed from a retrospective cohort study in the Brazilian population. 11 Similarly, they also suggested maternal age, FBG value, prior GDM, and FH of diabetes as indicators of insulin requirement. However, the study focused exclusively on the need for insulin therapy in women with early GDM diagnosis, thereby ignoring GDM development in later trimesters.…”

Section: Discussionmentioning

confidence: 98%

“…In our study, the percentage of insulin requirement among patients with GDM was 30.3%, which is consistent with that in previous studies. 11 , 16–18 Many studies have been performed to identify risk indicators for insulin requirement among GDM patients, 7 , 10 , 19 including a previous study by our group. 9 Only a few studies have integrated multiple indicators in a prediction model or scoring system in order to predict the risk of insulin requirement of every GDM-complicated pregnancy individually.…”

Section: Discussionmentioning

confidence: 98%

“…A nomogram for the prediction of insulin requirement during the treatment of early-diagnosed GDM in the Brazilian population has been developed. 11 However, different populations have different risk profiles, and the previous nomogram was exclusively for the prediction of insulin requirement in early-diagnosed GDM without survival-time (gestational age at initiation of insulin therapy) prediction. In the present study, we aimed to construct a nomogram for the estimation of individualized survival probabilities of insulin requirement in Chinese GDM patients.…”

Section: Introductionmentioning

confidence: 99%

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Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram

Du¹,

Li²

2021

DMSO

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Purpose This study sought to develop a nomogram for the prediction of insulin requirement in a Chinese population with gestational diabetes mellitus (GDM). Materials and Methods We performed a retrospective cohort study involving 626 Chinese women with GDM, of whom 188 were treated with insulin. “Least absolute shrinkage and selection operator” regression was used to optimize the independent predictors of insulin requirement during pregnancies complicated with GDM. Cox proportional hazards regression analysis was performed to establish a prediction model incorporating the selected predictors, and the nomogram was constructed to achieve individual prediction. The C-index, calibration plot and decision curve analysis were used to validate the model. Results Maternal age, family history of type 2 diabetes mellitus in a first-degree relative, a prior GDM history, fasting plasma glucose, hemoglobin A1c, gestational age, and body mass index values at the time of GDM diagnosis were the risk factors for insulin treatment. The model displayed medium predictive power with a C-index of 0.77 (95% confidence interval: 0.73–0.81) and relatively good calibration accuracies. The decision curve demonstrated a positive net benefit with a threshold between 0.09 and 0.70. Conclusion The findings suggest that our nomogram, incorporating seven indicators, is useful in predicting individualized survival probabilities of insulin requirement.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram

Du¹,

Li²

2021

DMSO

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“…GDM patients were mainly manifested as postprandial 2-h hyperglycemia [59]. This may be due to the fact that the postprandial insulin secretion of pregnancies with normal glucose metabolism is earlier than that of GDM patients, and glucose is associated with fast recovery in GDM patients [60,61]. After black garlic fermentation with L. bulgaricus , insulin resistance was improved in GDM women.…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus bulgaricus improves antioxidant capacity of black garlic in the prevention of gestational diabetes mellitus: a randomized control trial

Lin

Jia

et al. 2019

Bioscience Reports

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Objectives: Lactobacillus bulgaricus may improve antioxidant capacity of black garlic in the prevention of gestational diabetes mellitus (GDM).Methods: Black garlic was prepared with or without L. bulgaricus. Volatile and polysaccharides were analyzed by using LC-MS, Fourier Transform infrared (FTIR) and 13C nuclear magnetic resonance (NMR). The study design was parallel randomized controlled trial and 226 GDM patients were randomly assigned into BG (black garlic and L. bulgaricus) and CG (black garlic) groups, and allocation ratio was 1:1. The treatment duration was 40 weeks. Fasting blood glucose (FBG) and 1- and 2-h blood glucose (1hBG and 2hBG) after oral glucose tolerance test (OGTT) were detected. Antioxidant function of black garlic was determined by measuring plasma malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX) and total antioxidant capacity (T-AOC) in GDM patients. The comparison between two groups was made using two independent samples t test.Results: The intake of nutrients was similar between two groups (P>0.05). L. bulgaricus promoted the transformation of the glucopyranoside to glucofuranoside. L. bulgaricus increased the abilities of black garlic for scavenging hydroxyl radicals, 2,2′-azino-bis (3-ethylbenzenthiazoline-6-sulfonic) acid (ABTS) and DPPH free radicals. L. bulgaricus reduced the levels of FBG, 1hBG and 2hBG, and incidence of perinatal complications (P<0.01). Plasma MDA level in the BG group was lower than in the CG group, whereas the levels of SOD, GSH-PX and T-AOC in the BG group were higher than in the CG group (P<0.01).Conclusions: L. bulgaricus improves antioxidant capacity of black garlic in the prevention of GDM.

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Gestational diabetes mellitus - Neonatal and maternal outcomes in women treated with insulin or diet: A propensity matched analysis

Gupta,

Chawla

et al. 2024

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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Can we stratify the risk for insulin need in women diagnosed early with gestational diabetes by fasting blood glucose?

Cited by 15 publications

References 11 publications

Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram

Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram

Lactobacillus bulgaricus improves antioxidant capacity of black garlic in the prevention of gestational diabetes mellitus: a randomized control trial

Gestational diabetes mellitus - Neonatal and maternal outcomes in women treated with insulin or diet: A propensity matched analysis

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