Indicators of the need for insulin treatment and the effect of treatment for gestational diabetes on pregnancy outcomes in Japan
Indicators of the need for insulin treatment and the effect of treatment for gestational diabetes on pregnancy outcomes in Japan
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DOI：
10.1507/endocrj.ej15-0427
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发表时间：
2016-03-20
影响因子：
2
通讯作者：
Terauchi, Yasuo
中科院分区：
文献类型：
--
作者：
Ito, Yuzuru;Shibuya, Makoto;Terauchi, Yasuo
本研究评估了日本妊娠期糖尿病（GDM）患者胰岛素治疗需求的指标以及治疗对妊娠结局的影响。所有诊断为GDM的患者均住院3天。调查了严格饮食管理下患者的血糖谱以及每日血糖水平较高的GDM患者的特征。未能达到血糖目标的患者接受胰岛素治疗。研究了胰岛素治疗需求的指标。比较了接受饮食管理和胰岛素治疗的患者的妊娠结局。该研究包括112例GDM患者。GDM患者每日血糖水平高，在医院表现出显着较高的1小时和2小时血糖水平，口服葡萄糖耐量试验（OGTT）在诊断。在我院，102例单胎妊娠GDM患者随访至分娩; 32例（31.3%）接受胰岛素治疗。单因素分析表明，胰岛素需求与糖尿病家族史和诊断时1小时和2小时OGTT值显著相关。多因素分析显示，诊断时1小时OGTT血糖水平是胰岛素需求的独立预测因素。在围产期结局中，胰岛素治疗与低出生体重相关。
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.