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- W4200010443 abstract "Some lean women with gestational diabetes (GDM) are associated with having macrosomic infants and thus require intensive insulin therapy (IIT). We investigated the independent risk factors associated with requiring IIT during pregnancy. In this retrospective study, we included Japanese women with GDM diagnosed at 24 weeks’ gestation or later whose prepregnancy body mass index (BMI) was < 20 kg/m2. All patients underwent self-monitoring of blood glucose (SMBG) while receiving nutritional therapy, and insulin therapy was indicated if their SMBG did not reach target glucose levels. We defined the IIT group as those requiring ≥20 U/day of insulin and the non-IIT groups as those requiring < 20 U/day of insulin or being controlled with diet alone. Among the patient characteristics and diagnostic oral glucose test results, we investigated independent predictive factors associated with IIT using univariate and multivariate logistic regression analyses. Among 145 lean Japanese women with GDM whose prepregnancy BMI was 18.6 ± 1.1 kg/m2, we found 28 (19%) women requiring IIT. In the univariate analysis, we found a family history of diabetes, fasting and postprandial plasma glucose (PG) values, and HbA1c to be candidates for the multivariate analysis. In the multivariate analysis including those candidates, only fasting PG was significantly associated with IIT (p< 0.01). Women with a fasting PG ≥84 mg/dL (cut-off value derived from a receiver operating characteristic curve) was significantly associated with IIT with an adjusted odds ratio of 4.87 (95% confidence interval, 1.47-17.33) compared with those with values below the cut-off. In lean Japanese women with GDM, the fasting PG at the diagnostic oral glucose tolerance test was an independent predictive variable for IIT." @default.
- W4200010443 created "2021-12-31" @default.
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- W4200010443 date "2022-01-01" @default.
- W4200010443 modified "2023-09-28" @default.
- W4200010443 title "Risk factors associated with intensive insulin therapy in lean Japanese women with gestational diabetes" @default.
- W4200010443 doi "https://doi.org/10.1016/j.ajog.2021.11.1156" @default.
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