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Characterization of women with gestational diabetes who failed to achieve glycemic control by lifestyle modifications

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To identify specific characteristics of women diagnosed with gestational diabetes who failed to achieve good glycemic control by lifestyle modifications only.

Methods

Retrospective analysis of women carrying a singleton pregnancy diagnosed with gestational diabetes. The cohort included 314 women who achieved good glycemic control by lifestyle modifications and 328 women who required anti-diabetic medications. Lifestyle modifications included medical nutrition therapy and physical exercise recommendations. Anti-diabetic medications included either oral treatment with metformin or glyburide and\or insulin.

Results

Women in the lifestyle modifications group were younger (32.87 vs. 33.79 years, p = 0.012) and had lower pre-pregnancy body-mass-index (25.86 vs. 27.93 kg/m2, p < 0.001). Glucose challenge test (GCT) was significantly lower in the lifestyle modifications group (158.31 vs. 171.04 mg/dL in the anti-diabetic treatment group, p < 0.001). Moreover, fasting oral-glucose-tolerance-test (fOGTT) results were significantly lower in the lifestyle modifications group (88.22 vs. 96.34 mg/dL in the anti-diabetic treatment group, p < 0.001). In a receiver-operator-curve analysis, GCT + 4*fOGTT, was the best model to predict lifestyle modifications failure with an area under the curve of 0.7419. Higher rates of vaginal delivery and lower rates of maternal hypoglycemia in the lifestyle modifications group were observed.

Conclusions

Maternal baseline characteristics and diabetes diagnostic parameters may predict which women will fail to achieve good glycemic control solely by lifestyle modifications.

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Data availability

Data will be made available and transparent, in conjunction with a pre-approved and valid scientific questions and in concordance with ethical approval.

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Funding

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Authors and Affiliations

  1. Rabin Medical Center, Helen Schneider Hospital for Women, 4941492, Petach Tikva, Israel

    Eyal Krispin, Adi Ashkenazi Katz, Elyasaf Shmuel, Yoel Toledano & Eran Hadar

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Eyal Krispin, Adi Ashkenazi Katz, Elyasaf Shmuel, Yoel Toledano & Eran Hadar

Authors
  1. Eyal Krispin
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  2. Adi Ashkenazi Katz
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  3. Elyasaf Shmuel
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  4. Yoel Toledano
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  5. Eran Hadar
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Contributions

EK: protocol/project development, data collection or management, data analysis, manuscript writing/editing. AAK: data collection or management, data analysis, manuscript writing/editing. ES: protocol/project development, data collection or management, data analysis, manuscript writing/editing. YT: protocol/project development, data analysis, manuscript writing/editing. EH: protocol/project development, data analysis, manuscript writing/editing

Corresponding author

Correspondence to Eran Hadar.

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Conflict of interest

All authors declare that they have no conflict of interest and/or competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

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Waived, due to the retrospective design of the study.

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Waived, due to the retrospective design of the study.

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Krispin, E., Ashkenazi Katz, A., Shmuel, E. et al. Characterization of women with gestational diabetes who failed to achieve glycemic control by lifestyle modifications. Arch Gynecol Obstet 303, 677–683 (2021). https://doi.org/10.1007/s00404-020-05780-3

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  • DOI: https://doi.org/10.1007/s00404-020-05780-3

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