Analysis Of Factors Related To Insulin Therapy In Gestational Diabetes Mellitus

Purpose:To explore the factors related to insulin therapy in patients with GDM,and analyze the predictive value and clinical significance of these factors.Methods:Subjects:A total of 224 pregnant women diagnosed with GDM in the First Affiliated Hospital of Xinjiang Medical University from January 2020 to January 2021 were included in the study.Among them,50 pregnant women treated with insulin during pregnancy were included in the insulin treatment group,and 174 pregnant women only controlled blood glucose during pregnancy without drug treatment were included in the control group.The two groups were compared in terms of age,pre-pregnancy BMI,gestational times,family history of diabetes,past history of GDM,past history of large birth and other general information,biochemical test and oral glucose tolerance test(OGTT)in the first and middle stages of pregnancy.The predictive value and threshold of relevant factors were analyzed by ROC curve through statistical analysis.Results:The age and BMI of pregnant women in insulin treatment group were higher than those in control group(P<0.05).Pregnancy weight gain was lower than control group(P<0.05).There was statistical significance in gestational times and family history of diabetes between the two groups(P<0.05).There were statistically significant differences in blood white blood cells,neutrophils,lymphocytes,creatinine and uric acid between the two groups in early pregnancy(P<0.05).Serum high-density lipoprotein in insulin treatment group was lower than that in control group(P<0.05).OGTT results showed that the three values,glycosylated hemoglobin and blood triglyceride levels were higher than those of the control group(P<0.05).Conclusion:With age,prepregnancy BMI increases and the risk of insulin therapy for GDM increases.Multiple pregnancies and a family history of diabetes are closely related to insulin therapy in GDM patients.Age,BMI before pregnancy and family history of diabetes were independent risk factors.Age>32.5 years,serum creatinine>45.93(μmol/L)in the first trimester,hBA1c>5.9%in the second trimester,fasting blood glucose>5.6mmol/L,OGTTlh blood glucose>10.345mmol/L,Patients with GDM were more likely to require insulin treatment when OGTT2h blood glucose>10.03mmNOL/L,and OGTT had the highest predictive value of fasting blood glucose.