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Archives of Gynecology and Obstetrics

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01-03-2021 | Glibenclamide | Maternal-Fetal Medicine

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

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

Published in: Archives of Gynecology and Obstetrics | Issue 3/2021

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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Title: Characterization of women with gestational diabetes who failed to achieve glycemic control by lifestyle modifications
Authors: Eyal Krispin
Adi Ashkenazi Katz
Elyasaf Shmuel
Yoel Toledano
Eran Hadar
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keywords: Glibenclamide
Insulins
Metformin
Gestational Diabetes
Birth
Gestational Diabetes
Pregnancy
Hypoglycemia
Insulins
Lifestyle Modifications
Published in: Archives of Gynecology and Obstetrics / Issue 3/2021
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-020-05780-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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