BAYDUR ŞAHİN, Serap Recep Tayyip Erdoğan Üniversitesi - Tıp Fakültesi - Endokrinoloji ve Metabolizma Hastalıkları Anabilim Dalı, Turkey , AYAZ, Teslime Recep Tayyip Erdoğan Üniversitesi - Tıp Fakültesi - İç Hastalıkları Anabilim Dalı, Turkey , İLKKILIÇ, Kadir Recep Tayyip Erdoğan Üniversitesi - Tıp Fakültesi - İç Hastalıkları Anabilim Dalı, Turkey , SEZGİN, Hacer Recep Tayyip Erdoğan Üniversitesi - Tıp Fakültesi - Aile Hekimliği Anabilim Dalı, Turkey , METE URAL, Ülkü Recep Tayyip Erdoğan Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum Anabilim Dalı, Turkey

Risk Factors That Increase Insulin Need in Patients with Gestational Diabetes Mellitus

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Objective: Our aim was to determine the risk factors associated with the need for insulin therapy in patients with gestational diabetes mellitus (GDM). Material and Method: We enrolled 128 pregnant women who were diagnosed GDM by 75 gr oral glucose tolerance test (OGTT) at 24-28 week gestational weeks. The demographic features, insulin and HbA1c levels were evaluated. 35,2% of the patients needed insulin therapy during pregnancy. We compared patients with GDM who needed insulin therapy during pregnancy (insulin group) and women treated with diet alone (diet group). Results: The patients treated with insulin were older than the patients in diet group (32,0±0,6 vs, 34,7± 0,6; p=0.004). Prenatal body mass index (BMI) was significantly higher in the insulin group compared to the diet group (29±0,6 vs, 32± 0,8 kg/m2; p=0.004).While the mean fasting plasma glucose (FPG) levels was 101,6± 2,1 mg/dl in the insulin group, it was 92,7± 1,1 mg/dl in the diet group (p 0.001). While there was not a difference in OGTT 1 hour- plasma glucose levels between the two groups (p=0.069), 2 hour- plasma glucose levels were 159,1± 6,8 mg/dl in the insulin group and 143,1± 3,7 mg/dl in the diet group (p= 0.027). HbA1c level was significantly higher in the insulin group compared to the diet group (4,9± 0,1 vs, 5,3± 0,1; p= 0.001). There was not a difference in fasting insulin levels and HOMA-IR between the two groups (p=0.908, p=0.073). Conclusion: Age, family history of diabetes, prenatal BMI, FPG and HbA1c were found to be risk factors associated with insulin need in patients with GDM.

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Gestational diabetes mellitus , Insulin , Fasting plasma glucose , HbA1c , Diet , Perinatal outcome.

Fırat Medical Journal

196