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International Journal of Endocrinology
Volume 2016, Article ID 4858976, 5 pages
Research Article

Factors in Gestational Diabetes Mellitus Predicting the Needs for Insulin Therapy

Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University, No. 100 Haining Road, Shanghai 200080, China

Received 10 March 2016; Revised 1 April 2016; Accepted 10 May 2016

Academic Editor: Alexandra Kautzky-Willer

Copyright © 2016 Ya Zhang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To identify factors predicting the need for insulin therapy in pregnancies complicated by gestational diabetes mellitus (GDM). Methods. A total of 1352 patients with GDM diagnosed by the 75-g/2-h oral glucose tolerance test (OGTT) were enrolled in this study. Univariate and multivariate analysis were performed; receiver operating characteristics (ROC) were also drawn. Results. There was a significant difference in factors such as maternal age, pregestational BMI, first visit SBP, first visit DBP, FBG of first visit, FBG at time of OGTT, 75-g OGTT glucose value (fasting, after 1 h and 2 h), and serum HbA1c level at diagnosis between patients with insulin therapy and patients with medical nutrition therapy (MNT) alone. Multivariate analysis showed that higher FBG at time of OGTT, first 75 g OGTT 2 h plasma glucose, and HbA1c concentration at diagnosis lead to more likely need of insulin therapy. Conclusion. The probability of insulin therapy can be estimated in pregnant women with GDM based on fasting and 2 h glucose values during OGTT and HbA1c value at diagnosis of GDM.