Predictors and Outcomes in Gestational Diabetes Requiring Insulin Therapy

Ambreen Ehsan; Abida Aslam; Zahir-ud-Din Babar; Maryam Zubair; Sadaf Zohra; Shahzad Bashir Momina

doi:10.51253/pafmj.v74i3.10075

Authors

Ambreen Ehsan Department of Gynecology and Obstetrics, Combined Military Hospital Jhelum/National University of Medical Sciences (NUMS) Pakistan
Abida Aslam Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Zahir-ud-Din Babar Armed Forces Post Graduate Medical Institute/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Maryam Zubair Department of Gynecology and Obstetrics, Azad Jammu Kashmir Medical College Muzaffarabad, Azad Jammu & Kashmir, Pakistan
Sadaf Zohra Department of Gynecology and Obstetrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Shahzad Bashir Momina Department of Gynecology and Obstetrics, Combined Military Hospital Sargodha/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i3.10075

Keywords:

Birth weight, Gestational diabetes, Insulin requirement, Maternal age, Mode of delivery, Parity

Abstract

Objective: To evaluate risk factors that predict Insulin requirements and outcomes in women with gestational diabetes in a resource-limited country.

Study Design: Retrospective longitudinal study.

Place and Duration of Study: Department of Gynaecology and Obstetrics, Combined Military Hospital, Mangla Pakistan, from Jan to Dec 2019.

Methodology: Our study included 100 pregnant women with gestational diabetes over a period of one year. The primary outcome was to calculate the frequency of gestational diabetes and the correlation between maternal age and parity with subdermal Insulin therapy in a peripheral (Class C) hospital. The secondary outcomes of this study included mode of delivery and neonatal birth weight.

Results: Out of 1509 deliveries, our study included 100 pregnant women (6.62%). Sixty-two (62%) required Insulin to control hyperglycemia in addition to oral Metformin; 36% required oral Metformin alone. Maternal age (p=0.078), presence of co-morbidity (p=0.260), and parity (p=0.242) did not predict Insulin requirement. A caesarean section (69%) was the most common mode of delivery. Insulin requirements to control hyperglycemia didn’t correlate with mode of delivery (p=0.825). The neonatal birth weight was 3.30±0.33 kg in patients requiring Insulin versus 3.26±0.25 kg in other treatments (p=0.86). There was one intrauterine death.

Conclusion: The frequency of gestational diabetes was 6.62%. Maternal age, parity, and the presence of maternal co-morbidities did not predict Insulin requirements. There was no correlation between Insulin therapy, mode of delivery, or neonatal outcome.

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