Indicators of the need for insulin treatment and the effect of treatment for gestational diabetes on pregnancy outcomes in Japan

Yuzuru Ito; Makoto Shibuya; Saho Hosokawa; Yoko Motoki; Ryou Nagata; Hiromi Konishi; Takashi Miyazaki; Tatsuya Matsunaga; Yoshiyuki Nomura; Takashi Mihara; Shihou Ito; Ken Sugiura; Yasuo Terauchi

doi:10.1507/endocrj.EJ15-0427

ORIGINALS

Indicators of the need for insulin treatment and the effect of treatment for gestational diabetes on pregnancy outcomes in Japan

Yuzuru Ito, Makoto Shibuya, Saho Hosokawa, Yoko Motoki, Ryou Nagata, Hiromi Konishi, Takashi Miyazaki, Tatsuya Matsunaga, Yoshiyuki Nomura, Takashi Mihara, Shihou Ito, Ken Sugiura, Yasuo Terauchi

Author information

Yuzuru Ito
Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan
Department of Endocrinology and Metabolism, Yokosuka Kyosai Hospital, Yokosuka, Japan
Makoto Shibuya
Department of Endocrinology and Metabolism, Yokosuka Kyosai Hospital, Yokosuka, Japan
Saho Hosokawa
Department of Endocrinology and Metabolism, Yokosuka Kyosai Hospital, Yokosuka, Japan
Yoko Motoki
Department of Obstetrics and Gynecology, Yokosuka Kyosai Hospital, Yokosuka, Japan
Ryou Nagata
Department of Obstetrics and Gynecology, Yokosuka Kyosai Hospital, Yokosuka, Japan
Hiromi Konishi
Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan
Department of Endocrinology and Metabolism, Yokosuka Kyosai Hospital, Yokosuka, Japan
Takashi Miyazaki
Department of Endocrinology and Metabolism, Yokosuka Kyosai Hospital, Yokosuka, Japan
Tatsuya Matsunaga
Department of Obstetrics and Gynecology, Yokosuka Kyosai Hospital, Yokosuka, Japan
Yoshiyuki Nomura
Department of Obstetrics and Gynecology, Yokosuka Kyosai Hospital, Yokosuka, Japan
Takashi Mihara
Department of Obstetrics and Gynecology, Yokosuka Kyosai Hospital, Yokosuka, Japan
Shihou Ito
Hayashida ladies clinic, Kounosu, Japan
Ken Sugiura
Department of Obstetrics and Gynecology, Yokosuka Kyosai Hospital, Yokosuka, Japan
Yasuo Terauchi
Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan

Keywords: Gestational diabetes mellitus, Insulin therapy, Oral glucose tolerance test, Pregnancy outcome

JOURNAL FREE ACCESS

2016 Volume 63 Issue 3 Pages 231-237

DOI https://doi.org/10.1507/endocrj.EJ15-0427

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Details

Abstract

This study assessed indicators of the need for insulin therapy and the effect of treatment on pregnancy outcomes in Japanese patients with gestational diabetes mellitus (GDM). All patients diagnosed with GDM were hospitalized for three days. Plasma glucose profiles in patients under strict dietary management and the characteristics of GDM patients with high daily glucose levels were investigated. Patients who failed to achieve glycemic targets were treated with insulin. Indicators of the need for insulin treatment were investigated. Pregnancy outcomes in patients prescribed dietary management and patients prescribed insulin treatment were compared. The study included 112 patients with GDM. GDM patients with high daily glucose levels in the hospital exhibited significantly higher 1-h and 2-h plasma glucose levels in oral glucose tolerance tests (OGTTs) at diagnosis. In our hospital, 102 GDM patients with singleton pregnancies were followed until delivery; 32 (31.3%) were treated with insulin. Univariate analysis identified significant associations of insulin requirement with family history of diabetes and with 1-h and 2-h OGTT values at diagnosis. Multivariate analysis showed that the 1-h OGTT plasma glucose level at diagnosis was an independent predictor of the need for insulin. In perinatal outcomes, insulin treatment was associated with low birth weight.

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