Determinants of Insulin Therapy among Women with Gestational Diabetes Mellitus: A Cross-Sectional Study

Abstract

ABSTRACT Background: Gestational diabetes mellitus (GDM) is a common complication in pregnancy that occurs during the second half of pregnancy. In the majority of patients, medical nutritional therapy (MNT) alone is sufficient to achieve the glycemic goal. Aim: To evaluate the clinical and biochemical factors that predict the need for insulin therapy in women with GDM. Materials and Methods: Between March 2020 and November 2021, an analytic cross-sectional study was conducted on 127 women diagnosed with GDM at their final antenatal visit. Multivariate logistic regression was used to determine the variables associated with the likelihood of insulin requirement in patients with GDM. Results: To achieve glycemic control, 56.7% of the study population required insulin treatment. Fasting glucose, pre-conceptional body mass index (BMI), parity, and third-trimester glycated hemoglobin levels were all higher in the insulin-treated group (P = 0.00, 0.01, 0.01, and 0.02), respectively. Fasting glucose level is the main determinant of insulin use in patients with GDM (odds ratio [OR]: 1.110; 95% confidence interval [CI]: 1.001–1.191; P = 0.004). Conclusions: Fasting glucose level is the most important predictor of the need for insulin therapy.