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Assessment of predictors of insulin therapy in patients with gestational diabetes diagnosed according to the IADPSG criteria

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Abstract

Aims and introduction

It is helpful for both diabetologists and obstetricians to identify patients with gestational diabetes who require insulin therapy for glycemic control during pregnancy. The aim of the present study was to assess potential predictors of insulin requirement in patients with gestational diabetes.

Materials and methods

One hundred thirteen patients with gestational diabetes [mean age 34.2 ± 4.5 years; pre-gestational body mass index (BMI), 23.6 ± 6.0 kg/m2] were included in this study. The associations between insulin requirement and the following factors were analyzed: clinical maternal characteristics, number of abnormal oral glucose tolerance test (OGTT) values, gestational age at diagnosis, plasma glucose levels measured during the OGTT, glycated hemoglobin (HbA1c) and glycated albumin levels, and serum C-peptide level before breakfast and 1 and 2 h after breakfast.

Results

Thirty-six patients (32 %) required insulin during pregnancy (“insulin group”); the remaining patients were treated with nutrition therapy (“nutrition group”). The insulin group had a higher pre-gestational BMI, higher fasting glucose level, higher area under the curve (AUC) for serum C-peptide level, higher HbA1c level, and a younger gestational age at diagnosis than the nutrition group (p < 0.05, all). Logistic regression analysis showed that the pre-gestational BMI, AUC for serum C-peptide level, and the HbA1c level were independent predictors for the insulin group (p < 0.05, all).

Conclusions

The results suggest that a high insulin resistance and HbA1c level may be associated with insulin requirement in patients with gestational diabetes.

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Author information

Authors and Affiliations

  1. Diabetes Center, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Keiko Yanagisawa, Yasuhiko Ichimura, Misa Kambara, Asako Sato & Yasuko Uchigata

  2. Department of Medicine, Tokyo Women’s Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan

    Keiko Yanagisawa & Hiroshi Sakura

  3. Department of Obstetrics and Gynecology, Tokyo Women’s Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan

    Mitsue Muraoka & Koichiro Takagi

  4. Clinical Laboratory, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Asako Sato

Authors
  1. Keiko Yanagisawa
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  2. Mitsue Muraoka
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  3. Koichiro Takagi
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  4. Yasuhiko Ichimura
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  5. Misa Kambara
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  6. Asako Sato
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  7. Hiroshi Sakura
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  8. Yasuko Uchigata
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Corresponding author

Correspondence to Keiko Yanagisawa.

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Conflict of interest

H. Sakura received lecture fees from Mitsubishi Tanabe Pharma Corp. and research grants from Astra Zeneca K.K., Chugai Pharma Manufacturing Co., Ltd., Takeda Pharma Ltd., and Ono Pharmaceutical Co., Ltd. Y. Uchigata received lecture fees from Novo Nordisk Pharma Ltd., Sanofi K.K., Takeda Pharma Ltd., Mitsubishi Tanabe Pharma Corp., Ono Pharmaceutical Co., Eli Lilly Japan K.K., MSD K.K., and research grants from Novartis Phama K.K., Astellas Pharma Inc., Pfizer Japan Inc., Chugai Pharma Manufacturing Co., Ltd., Boehringer Ingerheim, Astra Zeneca K.K., Kyowa Hakko Kirin Co., Ltd., Alcon, Otsuka Pharmacuetical Co., Ltd., Nipro, Eli Lilly Japan K.K., Kowa Shinyaku Co., Ltd., Eizai Co., Ltd., Takeda Pharma Ltd., Sanofi K.K., Mitsubishi Tanabe Pharma Corp., MSD K.K., Ono Pharmaceutical Co., Novo Nordisk Phama Ltd., Terumo Corp., Sumitomo Dainippon Pharma Co., Ltd., and Diaiichu Sankyo Co., Ltd. The other authors declare that they have no conflict of interest.

Human rights statement and informed consent

All procedures conducted in this study were in accordance with the ethics committee of Tokyo Women’s Medical University and with the Declaration of Helsinki of 1964 and later revisions. Informed consent or a substitute for it was obtained from all patients before they were included in the study.

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Yanagisawa, K., Muraoka, M., Takagi, K. et al. Assessment of predictors of insulin therapy in patients with gestational diabetes diagnosed according to the IADPSG criteria. Diabetol Int 7, 440–446 (2016). https://doi.org/10.1007/s13340-016-0272-0

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  • DOI: https://doi.org/10.1007/s13340-016-0272-0

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