Comparative study of maternal and fetal outcome in gestational diabetes mellitus with non diabetic pregnancies

Background: Modern desk-bound lifestyle and unhealthy dietary changes have brought a rise in the prevalence of obesity and gestational diabetes mellitus (GDM). It is associated with severe hazards to the mother and the baby. It is mandatory that early diagnosis ensues and timely and congruous management is undertaken.Methods: In this observational study, 1250 women were included. A standardized questionnaire was formed and their details were noted. Tests for glucose levels, complete blood picture, urine examination were performed. An oral glucose tolerance test was performed on all the patients. Neonatal outcomes in terms of birth weight and the presence of complications were noted.Results: A total 201 (16.1%) of all women were having gestational diabetes mellitus (GDM). Most mothers were in the 25-30 age group. The majority of the women had a BMI between 26-30. 21.9% of babies were having weight >3.5 kgs. 11.4% of babies were <2.5 kgs. Out of 201 neonates, 90 babies were having complications. Major complications in neonates were macrosomia and respiratory distress. Therefore, early diagnosis, glycemic control, and timely and congruous management are advantageous to both mother and baby.Conclusions: GDM complicating the pregnancy results in a higher prevalence of complications in the mother and the neonate. Therefore, appropriate control of the sugar level in mothers is necessary and it decreases the morbidity and mortality rates in the babies as well as the mothers.

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Comparative Study on Clinical Characteristics and Outcomes of Overt Diabetes Mellitus and Gestational Diabetes Mellitus in Late Pregnancy

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2020.10100125 ◽

2020 ◽

Vol 10 (10) ◽

pp. 1358-1369

Author(s):

Rui Wang ◽

Suping Wu

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Comparative Study ◽

Clinical Characteristics ◽

Late Pregnancy ◽

Overt Diabetes

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Oral Hypoglycemic Glibenclamide: Can it be a Substitute to Insulin in the Management of Gestational Diabetes Mellitus? A Comparative Study

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1167 ◽

2012 ◽

Vol 4 (1) ◽

pp. 28-31 ◽

Cited By ~ 21

Author(s):

Partha Mukhopadhyay ◽

Tara Sankar Bag ◽

Amit Kyal ◽

Dipta Prasun Saha ◽

Noori Khalid

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Birth Weight ◽

Glycemic Control ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Comparative Study ◽

Blood Sugar ◽

Group A ◽

Group B

ABSTRACT Introduction Gestational diabetes is a common medical disorder in pregnancy. So long, it has been usually treated by insulin. Now it has been found that oral glibenclamide can be used instead of insulin with similar glycemic control and without any adverse maternal and fetal effect. Methods A comparative study between oral glibenclamide and insulin for the management of gestational diabetes mellitus (GDM) was conducted. It was a prospective randomized study and patients attending the antenatal clinic were screened with 75 gm oral glucose between 20 to 28 weeks and GDM was diagnosed based on WHO criteria of 2 hours blood glucose ≥140 mg/dl. Women with gestational diabetes were given medical nutritional therapy (MNT) for 2 weeks. Out of this, 60 women did not achieve the target blood glucose. The goal of treatment was maintenance of mean plasma glucose (MPG) of about 105 mg%. For this the fasting plasma glucose should be around 90 mg/dl and postprandial peaks around 120 mg/dl. Patients were randomly assigned to receive glibenclamide (group A, n = 30) or insulin (group B, n = 30). In group A, glibenclamide was given 2.5 mg orally in morning and doses were increased weekly by 2.5 mg up to a maximum of 20 mg and doses >7.5 mg were given in two divided doses. In group B, insulin 0.7 units per kilogram of body weight at admission was given subcutaneously three times daily and increased weekly as necessary. Self monitoring of blood glucose with glucometer was done. Blood glucose was also measured from the laboratory every week. Glycosylated hemoglobin (HbA1c) was measured before initiation of therapy and repeated in the third trimester before confinement. Terminations of pregnancy in both the groups were done between 37 and 38 weeks. The infant birth weight, blood glucose and serum bilirubin were also recorded in all cases. Results The present study showed that the two groups had similar glycemic status (fasting blood sugar in group A was 103.5 ± 14.62 mg/dl and postprandial blood sugar was 184.1 ± 20.46 mg/dl whereas in group B it was109.3 ± 19.63 mg/dl and 194.3 ± 18.47mg/dl) at the time of entry into the study. The two groups also showed similar levels of glycemic control just before confinement (fasting blood sugar in group A was 88.23 ± 6.55 mg/ dl and postprandial blood sugar was 122.7 ± 10.3 mg/dl whereas in group B it was 88.17 ± mg/dl and 128 ± 12.38 mg/dl) and there was no significant statistical difference in the two groups (p > 0.05). The perinatal outcomes in both the groups were also nearly same. There was no significant difference in birth weight, blood sugar level of neonates and complications between the two groups. There was no case of macrosomia in the two groups and the number of infants large for gestational age (LGA) was four in group A and two in group B. Hypoglycemia in newborn was slightly higher in the group A compared to group B (4 and 3 respectively). Conclusion From our study, it is evident that the use of oral agents is a pragmatic alternative to insulin therapy in cases of gestational diabetes because of similar glycemic control, ease of administration and better patient compliance due to noninvasive treatment. How to cite this article Mukhopadhyay P, Bag TS, Kyal A, Saha DP, Khalid N. Oral Hypoglycemic Glibenclamide: Can it be a Substitute to Insulin in the Management of Gestational Diabetes Mellitus? A Comparative Study. J South Asian Feder Obst Gynae 2012;4(1):28-31.

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Comparative study of neonatal and maternal adverse outcomes in women with gestational diabetes mellitus followed or treated with insulin versus dietary regimen

Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi ◽

10.38136/jgon.895195 ◽

2021 ◽

Author(s):

Mehmet Ufuk CERAN

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Comparative Study ◽

Adverse Outcomes ◽

Dietary Regimen

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Polycystic ovarian syndrome and pregnancy outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20173625 ◽

2017 ◽

Vol 6 (9) ◽

pp. 3804

Author(s):

Chaitra Shivananjaiah ◽

Abinaya Kannan ◽

Mridula Devi ◽

. Jayanthi ◽

Satish D. ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Age ◽

Polycystic Ovarian Syndrome ◽

Mode Of Delivery ◽

Fetal Outcome ◽

Hypertensive Disorder ◽

Ovarian Syndrome ◽

In Pregnancy

Background: Polycystic ovarian syndrome (PCOS) in the present generation is a very common reproductive disorder and the prevalence is on the rise. It is associated with typical features such as insulin resistance, hyperandrogenemia and obesity which has deep implications on the pregnancy outcomes as well as a long-term health of the woman.Methods: Prospective comparative study performed over 200 pregnant women in the ESIC medical college, Bangalore. 100 women diagnosed with PCOS were compared with that of 100 normal women. The method of conception in pcos was recorded. maternal outcome in the form of abortion, gestational diabetes mellitus, hypertensive disorder in pregnancy, mode of delivery, intrapartum and postpartum complication. Fetal outcome in the form preterm delivery, small-for-gestational-age (SGA) infants, large-for-gestational-age infants, apgar at 5 minute and admission to NICU.Results: Of the 100 women who were diagnosed with PCOS, 62 had spontaneous conception, 32 conceived with ovulation induction, 4 with artificial insemination and 2 needed IVF for conception. 18 women had spontaneous abortion, 58 were diagnosed with Gestational diabetes mellitus (GDM) predominantly between 24 – 28 weeks’ period of gestation, 16 women had hypertension complicating pregnancy. Fetal outcome in the form of preterm birth was noted in 14 patients, large for gestation was noted in 11 newborns, the rate of NICU admission was significantly higher in the PCOS women’s infants constituting 33%.Conclusions: The assistance needed for conception was significantly higher in women with PCOS. The complications associated with pregnancy such as spontaneous abortions, gestational diabetes, hypertensive disorder in pregnancy, preterm births, need of NICU care for the infants are much higher in women with PCOS. Adult health education and the preconception diagnosis and appropriate management of PCOS is an important primary mode of prevention of these associated complications.

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