Poster Presentation ESA-SRB 2023 in conjunction with ENSA

The comparison of pregnancy outcomes between diet and insulin treatment in women with GDM: a case-control study (#244)

George Q Chen 1 , Lin Wang 2 , Yue Wang 2 , Minghui Qin 2 , Dengxin Zhang 2 , Yanfang Gu 2 , Qi Chen 3 , Min Zhao 2
  1. Royal Liverpool University Hospital, , Liverpool, the United Kingdom
  2. Wuxi Maternity and Children Health Hospital, Wuxi, China
  3. The University of Auckland, Grafton, Auckland, New Zealand

Gestational diabetes mellitus (GDM) affects 15% of all pregnancies, with serious consequences for mothers and babies. GDM women normally receive lifestyle intervention or insulin treatment. However, there were no criteria for the option of treatment. We undertook this study to compare pregnancy outcomes between GDM women managed by lifestyle intervention and insulin treatment after diagnosis. Additionally, we investigated the impact of normal and abnormal glucose levels of oral glucose tolerance tests (OGTT) on pregnancy outcomes in GDM women with lifestyle intervention.

Data on maternal age at diagnosis, gestational age at diagnosis and delivery, birthweight, Apgar score, pregnancy complications, and weekly weight gain were collected. Pregnancy outcomes were compared between the lifestyle intervention (n=309) and insulin treatment (n=45) groups. We also analysed pregnancy outcomes in GDM women with lifestyle intervention based on normal or abnormal glucose levels of an OGTT.

The mean gestational age at delivery was no difference between the two groups. There was no difference in glucose level in 0h-OGTT or 2h-OGTT between the two groups. No statistical difference in the incidence of LGA, should dystocia, preeclampsia, and planned or emergency caesarean sections between the two groups. Additionally, there were no differences in pregnancy outcomes in GDM with lifestyle intervention, whether they had a normal or abnormal glucose level of an OGTT. Furthermore, there was no difference in the number of GDM women with abnormal fasting glucose levels at delivery between lifestyle intervention and insulin treatment, and there was no difference in adverse pregnancy outcomes between these two groups.  

Although there is no international guideline for insulin treatment in GDM, our data demonstrate no difference in adverse pregnancy outcomes between lifestyle intervention and insulin treatment. Additionally, there were no differences in adverse pregnancy outcomes in GDM women with abnormal glucose levels at delivery between lifestyle intervention and insulin treatment.