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- Title
Can Common Clinical Parameters Be Used to Identify Patients Who Will Need Insulin Treatment in Gestational Diabetes Mellitus?
- Authors
PERTOT, TANIA; MOLYNEAUX, LYNDA; TAN, KRIS; ROSS, GLYNIS P.; YUE, DENNIS K.; WONG, JENCIA
- Abstract
OBJECTIVE--To identify patients with gestational diabetes mellitus (GDM) who will need antenatal insulin treatment (AIT) by using a risk-prediction tool based on maternal clinical and biochemical characteristics at diagnosis. RESEARCH DESIGN AND METHODS--Data from 3,009 women attending the Royal Prince Allied Hospital GDM Clinic, Australia, between 1995 and 2010 were studied. A risk engine was developed from significant factors identified for AIT using a logistic regression model. RESULTS--A total of 51% of GDM patients required AIT. Ethnicity, gestation at diagnosis, HbA1c, fasting and 60-min glucose at oral glucose tolerance test, BMI, and diabetes family history were significant independent determinants of AIT. Notably, only 9% of the attributable risk for AIT can be explained by the clinical factors studied. A modeled risk-scoring system was therefore a poor predictor of AIT. CONCLUSIONS--Baseline maternal characteristics including HbA1c alone cannot predict the need for AIT in GDM. Lifestyle, compliance, or as yet unmeasured influences play a greater role in determining AIT.
- Subjects
PATIENTS; GESTATIONAL diabetes; INSULIN; ENDOCRINE diseases; DIABETES
- Publication
Diabetes Care, 2011, Vol 34, Issue 10, p2214
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/dc11-0499