Predictors of Insulin Treatment During Pregnancy and Abnormal Postpartum Glucose Metabolism in Patients with Gestational Diabetes Mellitus

BACKGROUND: To investigate the potential predictors of insulin treatment during pregnancy and abnormal postpartum glucose metabolism in gestational diabetes mellitus (GDM). METHODS: A total of 534 patients with GDM, who were diagnosed based on 75 g oral glucose tolerance test (OGTT) during pregnancy, were divided into the diet group (n=354) and insulin group (n=180) according to the treatment of hyperglycemia in pregnancy. Based on 75 g OGTT after delivery, 178 of the 534 patients were divided into the normal glucose tolerance (NGT; n=104) and the abnormal glucose tolerance (AGT; n=74) groups. Characteristics and metabolic indicators were compared. Logistic regression analysis was developed to assess the potential predictors of insulin treatment and abnormal postpartum glucose metabolism. Receiver operating characteristic curve was performed to determine the cut-off values. RESULTS: <0.05), and the cut-off of FPG was 5.7 mmol/L. CONCLUSION: Patients with FPG >5.7 mmol/L, 1 h plasma glucose >11.4 mmol/L, or HbA1c >5.3% at GDM diagnosis required insulin treatment, and patients with FPG >5.7 mmol/L had a greater risk of abnormal postpartum glucose metabolism. FPG at GDM diagnosis was the most important predictor.