Factors predicting the need for insulin therapy in patients with gestational diabetes mellitus

Sapienza, Andréia David; Francisco, Rossana Pulcineli Vieira; Trindade, Thatianne Coutheux; Zugaib, Marcelo

doi:10.1016/j.diabres.2009.12.023

Cited by 71 publications

(90 citation statements)

References 21 publications

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“…Several studies have described risk factors that indicate a need for insulin therapy for glycemic control in patients with GDM [10][11][12][13][14][15][16][17]. Fasting hyperglycemia measured with a diagnostic OGTT has been identified as an independent predictor of the need for insulin therapy [10][11][12][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Indicators of the need for insulin treatment and the effect of treatment for gestational diabetes on pregnancy outcomes in Japan

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Indicators of the need for insulin treatment and the effect of treatment for gestational diabetes on pregnancy outcomes in Japan

et al. 2016

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“…at <25 weeks gestation), a family history of diabetes, nonEuropean ethnicity, an older age, elevated fasting blood glucose level (BGL) and HbA 1c at GDM diagnosis, and an elevated pre-pregnancy BMI [3][4][5][6][7][8][9][10][11][12]. Despite the identification of individual independent predictors of the need for insulin therapy in GDM, only a few studies have attempted to use these factors to develop a model for predicting therapy type (either MNT or MNT+I) in women with GDM [3,5,11]. For those that have made such an attempt, success has been limited.…”

Section: Introductionmentioning

confidence: 99%

“…A number of studies have successfully identified one or more clinical or biochemical characteristics present at the time of GDM diagnosis that are associated with the need for insulin treatment [3][4][5][6][7][8][9][10][11][12]. These include early GDM diagnosis (e.g.…”

Section: Introductionmentioning

confidence: 99%

A novel validated model for the prediction of insulin therapy initiation and adverse perinatal outcomes in women with gestational diabetes mellitus

et al. 2016

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Aims/hypothesis Identifying women with gestational diabetes mellitus who are more likely to require insulin therapy vs medical nutrition therapy (MNT) alone would allow risk stratification and early triage to be incorporated into risk-based models of care. The aim of this study was to develop and validate a model to predict therapy type (MNT or MNT plus insulin [MNT+I]) for women with gestational diabetes mellitus (GDM). Methods Analysis was performed of de-identified prospectively collected data from women diagnosed with GDM by criteria in place since 1991 and formally adopted and promulgated as part of the more detailed 1998 Australasian Diabetes in Pregnancy Society management guidelines. Clinically relevant variables predictive of insulin therapy by univariate analysis were dichotomised and included in a multivariable regression model. The model was tested in a separate clinic population. Results In 3317 women, seven dichotomised significant independent predictors of insulin therapy were maternal age >30 years, family history of diabetes, pre-pregnancy obesity (BMI ≥30 kg/m 2 ), prior GDM, early diagnosis of GDM (<24 weeks gestation), fasting venous blood glucose level (≥5.3 mmol/l) and HbA 1c at GDM diagnosis ≥5.5% (≥37 mmol/mol). The requirement for MNT+I could be estimated according to the number of predictors present: 85.7-93.1% of women with 6-7 predictors required MNT+I compared with 9.3-14.7% of women with 0-1 predictors. This model predicted the likelihood of several adverse outcomes, including Caesarean delivery, early delivery, large for gestational age and an abnormal postpartum OGTT. The model was validated in a separate clinic population. Conclusions/interpretation This validated model has been shown to predict therapy type and the likelihood of several adverse perinatal outcomes in women with GDM.

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“…Sapienza et al reported that the probability of insulin therapy could be estimated in pregnant women with traditional GDM based on pre-pregnancy BMI, family history of diabetes, the number of abnormal points on a 100-g OGTT, and HbA1c concentration [23]. The probability of insulin requirement is directly linked to a higher sum of these quantified factors.…”

Section: Discussionmentioning

confidence: 99%

“…Although predictive factors for insulin therapy in pregnant women with OAV have not been reported, some articles describe the prediction of insulin therapy in pregnant women with traditional GDM [23][24][25]. Sapienza et al reported that the probability of insulin therapy could be estimated in pregnant women with traditional GDM based on pre-pregnancy BMI, family history of diabetes, the number of abnormal points on a 100-g OGTT, and HbA1c concentration [23].…”

Section: Discussionmentioning

confidence: 99%

Prognosis of Pregnant Women with One Abnormal Value on 75g OGTT

Kozuma¹,

Inoue

Horinouchi

et al. 2014

Kurume Med. J.

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Factors predicting the need for insulin therapy in patients with gestational diabetes mellitus

Cited by 71 publications

References 21 publications

Indicators of the need for insulin treatment and the effect of treatment for gestational diabetes on pregnancy outcomes in Japan

Indicators of the need for insulin treatment and the effect of treatment for gestational diabetes on pregnancy outcomes in Japan

A novel validated model for the prediction of insulin therapy initiation and adverse perinatal outcomes in women with gestational diabetes mellitus

Prognosis of Pregnant Women with One Abnormal Value on 75g OGTT

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