Risk Factors for the Requirement of Antenatal Insulin Treatment in Gestational Diabetes Mellitus

Abstract

Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM) is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT) are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group; n = 10) and without insulin therapy (Diet group; n = 27). The 1-h and 2-h plasma glucose levels and the number of abnormal values in 75 g OGTT were significantly higher in AIT group compared with Diet group. By logistic regression analysis, plasma glucose level at 1-h was significant predictor for AIT and the odds ratios were 1.115 (1.004–1.239) using forward selection method and 1.192 (1.006–1.413) using backward elimination method. There were no significant differences in obstetrical outcomes and neonatal complications. 1-h plasma glucose levels in 75 g OGTT are useful parameters in predicting the requirement for AIT in GDM. Both maternal and neonatal complications are comparable in GDM patients with and without insulin therapy.

One‐hour oral glucose tolerance test plasma glucose at gestational diabetes diagnosis is a common predictor of the need for insulin therapy in pregnancy and postpartum impaired glucose tolerance

“…In the first study, logistic regression analysis showed that gestational weeks at GDM diagnosis, plasma glucose levels in a 75‐g OGTT at 1 h and HbA1c were significant predictors for insulin therapy. Similar to the present results , other studies showed that plasma glucose levels in a 75‐g OGTT at 1 h and HbA1c were associated with the need for insulin therapy. In particular, Watanabe et al .…”

“…Similar to the present results , other studies showed that plasma glucose levels in a 75‐g OGTT at 1 h and HbA1c were associated with the need for insulin therapy. In particular, Watanabe et al . and Ito et al .…”

“…and Ito et al . analyzed Japanese GDM patients and reported that only 1‐h glucose levels in a 75‐g OGTT at diagnosis was an independent predictor of the need for insulin. Although sample sizes were not large (37 and 112, respectively) in these two studies, in combination with the present results, 1‐h glucose levels in a 75‐g OGTT might be a useful parameter in predicting the need for insulin therapy in Japanese GDM patients.…”

Retracted:MicroRNA‐219 decreases hippocampal long‐term potentiation inhibition and hippocampal neuronal cell apoptosis in type 2 diabetes mellitus mice by suppressing theNMDARsignaling pathway

“…The most important cause of cognitive dysfunction in diabetes is that it can lead to hippocampal damage . Strict diet is a prerequisite for the treatment of diabetes . Recently, a number of researches have confirmed that microRNAs (miRs) play an important role in the biological processes that lead to the development of T2DM, such as pathogenesis of hepatic insulin resistance …”

“…8 Strict diet is a prerequisite for the treatment of diabetes. 9 Recently, a number of researches have confirmed that microRNAs (miRs) play an important role in the biological processes that lead to the development of T2DM, such as pathogenesis of hepatic insulin resistance. [10][11][12] MiRs are known to have the ability to regulate inflammation, synaptic strength, ion channels, neuronal and glial function, and apoptosis.…”