Influence of initiation of insulin therapy at different gestational weeks for gestational diabetes on pregnancy outcomes

Abstract

Objective To investigate the influence of initiation of insulin therapy at different gestational weeks on pregnancy outcomes of patients with gestational diabetes. Methods Ninety-four patients with gestational diabetes who were treated in Jincheng Maternal and Child Health-Care Hospital from January 2016 to February 2018 were selected; according to their gestational ages, patients were divided into study group and routine group, with 47 cases in each group. Patients in study group were treated immediately after been diagnosed with diabetes, and patients in routine group were treated at 32 weeks of pregnancy. The blood glucose levels at the time of admission and before pregnancy were compared between the two groups; the mode of delivery and maternal-infant outcomes were compared between the two groups. Results The blood glucose levels of the two groups were higher at the time of admission, and there was no significant difference in it between the two groups (P>0.05). After treatment, the blood glucose levels of both groups were decreased, and levels of fasting blood glucose and 2-hour postprandial blood glucose in study group were significantly lower than those at admission and those in routine group (P 0.05). The positive rate of urine sugar and urine ketone (14.89%, 21.28%) in study group was lower than that in routine group (40.43%, 36.17%), and the cesarean section rate (8.51%) of study group was lower than that of routine group (29.89%), the total incidence of undesirable pregnancy (preterm labor, pregnancy hypertension and postpartum hemorrhage, 10.64%) was lower than that of routine group (34.04%), the difference was statistically significant (P<0.05). The total incidence of perinatal adverse events (neonatal asphyxia, neonatal hypoglycemia, low weight infant or giant infant) in study groups was 8.51%, which was lower than that in routine group (36.17%, P<0.05). Conclusions For patients with gestational diabetes, using insulin immediately after diagnosis is more effective in controlling patients’ blood glucose levels, and it can reduce the incidence of pregnancy complications and adverse conditions of perinatal children, which has great significance in promotion of maternal and child health. Key words: Gestational age; Insulin; Gestational diabetes; Pregnancy outcome