J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 5, Number 5, October 2013, pages 381-388

Risk Factors That can Predict Antenatal Insulin Need in Gestational Diabetes

Figure 1. Receiver operating characteristic curve (ROC) exhibiting fasting plasma glucose during OGTT at prediction of insulin requirement. AUC 0.734, cutofflevel: 89.5 mg/dL, Sensitivity: 72.7% Specifity: 62.6%, P = 0.001.

**Table 1.** Comparison of Pregestational and Gestational Factors Between Patients With MNT Only and Those With AIT
	Factors	Patients with MNT only (n = 190)	Patients with AIT (n = 110)	P
MNT: medical Nutrition Therapy; AIT: Antenatal insulin treatment; Mean ± Standard deviation, Median (Minimum-Maximum).
Pregestational Factors	positive family history (n)	88 (46.3%)	64 (58.2)	0.031
	pregestational BMI (kg/m²)	26.2 ± 4.3	27.7 ± 5.5	0.122
	Parity	2 (1 - 8)	2 (1 - 8)	0.805
	history of GDM (n)	46 (24.2%)	32 (29%)	0.391
	macrosomic baby birth history (n)	11 (6.2%)	10 (%9.8)	0.190
Gestational Factors	age (year)	32.9 ± 4.6	32.9 ± 4.9	0.914
	diagnosis time (gestational week)	26.1 ± 5.1	27.6 ± 4.4	0.008
	BMI at diagnosis (kg/m²)	30.2 ± 4.6	31.6 ± 4.9	0.049
	weight gain until diagnosis (kg)	9.2 (0 - 16.2)	8.6 (2 - 18.3)	0.945
	systolic blood pressure during diagnosis (mmHg)	114.5 ± 8.8	113.6 ± 5.9	0.532
	diastolic blood pressure during diagnosis (mmHg)	69.2 ± 7.9	69.0 ± 7.9	0.089
	HbA1C during diagnosis (%)	5.3 ± 0.6	5.6 ± 0.6	0.001
	Fasting plasma glucose during OGTT (mg/dL)	87.5 ± 11.2	97.3 ± 12.1	0.0001

Table 1. Comparison of Pregestational and Gestational Factors Between Patients With MNT Only and Those With AIT

Factors

Patients with MNT only (n = 190)

Patients with AIT (n = 110)

MNT: medical Nutrition Therapy; AIT: Antenatal insulin treatment; Mean ± Standard deviation, Median (Minimum-Maximum).

Pregestational Factors

positive family history (n)

88 (46.3%)

64 (58.2)

0.031

pregestational BMI (kg/m²)

26.2 ± 4.3

27.7 ± 5.5

0.122

Parity

2 (1 - 8)

0.805

history of GDM (n)

46 (24.2%)

32 (29%)

0.391

macrosomic baby birth history (n)

11 (6.2%)

10 (%9.8)

0.190

Gestational Factors

age (year)

32.9 ± 4.6

32.9 ± 4.9

0.914

diagnosis time (gestational week)

26.1 ± 5.1

27.6 ± 4.4

0.008

BMI at diagnosis (kg/m²)

30.2 ± 4.6

31.6 ± 4.9

0.049

weight gain until diagnosis (kg)

9.2 (0 - 16.2)

8.6 (2 - 18.3)

0.945

systolic blood pressure during diagnosis (mmHg)

114.5 ± 8.8

113.6 ± 5.9

0.532

diastolic blood pressure during diagnosis (mmHg)

69.2 ± 7.9

69.0 ± 7.9

0.089

HbA1C during diagnosis (%)

5.3 ± 0.6

5.6 ± 0.6

0.001

Fasting plasma glucose during OGTT (mg/dL)

87.5 ± 11.2

97.3 ± 12.1

0.0001

**Table 2.** Regression Analysis Demonstrating Fasting Glucose Level at OGTT and HbA1C at Diagnosis as Independent Predictors for Insulin Requirement in Gestational Diabetes Mellitus
	B	S.E.	Wald	df	P	Odd Ratio	95% C.I. for EXP(B)
a. Variable(s) entered on step 1 positive family history, time of diagnosis (gestational week), BMI at diagnosis, HbA1C at time of diagnosis, Fasting plasma glucose on OGTT.
positive family history	0.351	0.367	0.918	1	0.338	1.421	0.692	2.916
Diagnosis time (gestational week)	-0.046	0.044	1.115	1	0.291	0.955	0.876	1.040
BMI at diagnosis	0.026	0.038	0.458	1	0.499	1.026	0.952	1.106
HbA1C during diagnosis	0.680	0.316	4.635	1	0.031	1.974	1.063	3.666
Fasting plasma glucose at OGTT	0.062	0.016	14.947	1	0.0001	1.064	1.031	1.098
Constant	-9.682	2.665	13.203	1	0.0001	0.000

Table 2. Regression Analysis Demonstrating Fasting Glucose Level at OGTT and HbA1C at Diagnosis as Independent Predictors for Insulin Requirement in Gestational Diabetes Mellitus

S.E.

Wald

Odd Ratio

95% C.I. for EXP(B)

Lower

Upper

a. Variable(s) entered on step 1 positive family history, time of diagnosis (gestational week), BMI at diagnosis, HbA1C at time of diagnosis, Fasting plasma glucose on OGTT.

positive family history

0.351

0.367

0.918

0.338

1.421

0.692

2.916

Diagnosis time (gestational week)

-0.046

0.044

1.115

0.291

0.955

0.876

1.040

BMI at diagnosis

0.026

0.038

0.458

0.499

1.026

0.952

1.106

HbA1C during diagnosis

0.680

0.316

4.635

0.031

1.974

1.063

3.666

Fasting plasma glucose at OGTT

0.062

0.016

14.947

0.0001

1.064

1.031

1.098

Constant

-9.682

2.665

13.203

0.0001

0.000

**Table 3.** Odds Ratio and 95% CI for Fasting Plasma Glucose During OGTT and HbA1C at Diagnosis
	Value	95% Confidence Interval
Odds ratio for fasting plasma glucose (89.5 mg/dL)	4.469	2.678	7.460
Odds ratio for HbA1C (5.485%)	3.760	2.053	6.887

Table 3. Odds Ratio and 95% CI for Fasting Plasma Glucose During OGTT and HbA1C at Diagnosis

Value

95% Confidence Interval

Lower

Upper

Odds ratio for fasting plasma glucose (89.5 mg/dL)

4.469

2.678

7.460

Odds ratio for HbA1C (5.485%)

3.760

2.053

6.887