Serap BAYDUR ŞAHİN, Teslime AYAZ, Kadir İLKKILIÇ, Hacer SEZGİN, Ülkü METE URAL

Gestasyonel Diyabette İnsülin Tedavi Gereksinimini Artıran Risk Faktörleri

ÖZET Amaç: Çalışmanın amacı gestasyonel diyabetes mellitus (GDM) olgularında insülin tedavisi gereksinimini artıran risk faktörlerini incelemekti. Gereç ve Yöntem: Çalışmaya gebeliğin 24-28. haftalarında 75 gr oral glukoz tolerans testi (OGTT) ile GDM tanısı konulan 128 gebe alındı. Hastaların demografik özellikleri, tanı anındaki açlık insülin ve HbA1c düzeyleri değerlendirildi. Hastaların gebelik süresince %35,2sinde insulin gereksinimi oldu. Araştırmaya alınan olgular gebelik izleminde insülin tedavisi gereken olgular (insulin grubu) (n=45) ile sadece diyet ile izlenen olgular (diyet grubu) (n=83) şeklinde iki gruba ayrıldı. Bulgular: İnsülin grubunun yaş ortalaması diyet grubununkine göre anlamlı olarak daha yüksekti (32±0,6ya karşın 34,7± 0,6; p=0.004). Gebelik öncesi vücut kitle indeksi (VKİ) değerleri insulin grubunda anlamlı olarak daha yüksekti (29±0,6ya karşın 32± 0,8 kg/m2; p=0.004). OGTT esnasındaki açlık kan şekeri (AKŞ) insulin grubunda 101,6± 2,1 mg/dl iken, diyet grubunda 92,7± 1,1 mg/dl idi (p

Risk Factors That Increase Insulin Need in Patients with Gestational Diabetes Mellitus

Objective: Our aim was to determine the risk factors associated with the need for insulin therapy in patients with gestational diabetes mellitus (GDM). Material and Method: We enrolled 128 pregnant women who were diagnosed GDM by 75 gr oral glucose tolerance test (OGTT) at 24-28 week gestational weeks. The demographic features, insulin and HbA1c levels were evaluated. 35,2% of the patients needed insulin therapy during pregnancy. We compared patients with GDM who needed insulin therapy during pregnancy (insulin group) and women treated with diet alone (diet group). Results: The patients treated with insulin were older than the patients in diet group (32,0±0,6 vs, 34,7± 0,6; p=0.004). Prenatal body mass index (BMI) was significantly higher in the insulin group compared to the diet group (29±0,6 vs, 32± 0,8 kg/m2; p=0.004).While the mean fasting plasma glucose (FPG) levels was 101,6± 2,1 mg/dl in the insulin group, it was 92,7± 1,1 mg/dl in the diet group (p<0.001). While there was not a difference in OGTT 1 hour- plasma glucose levels between the two groups (p=0.069), 2 hour- plasma glucose levels were 159,1± 6,8 mg/dl in the insulin group and 143,1± 3,7 mg/dl in the diet group (p= 0.027). HbA1c level was significantly higher in the insulin group compared to the diet group (4,9± 0,1 vs, 5,3± 0,1; p= 0.001). There was not a difference in fasting insulin levels and HOMA-IR between the two groups (p=0.908, p=0.073). Conclusion: Age, family history of diabetes, prenatal BMI, FPG and HbA1c were found to be risk factors associated with insulin need in patients with GDM.

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