doiSerbia

Changes in parameters of glycoregulation in gestational diabetes mellitus patients with different approach to insulin therapy introduction

Mladenović Violeta (Centar za endokrinologiju, dijabetes i bolesti metabolizma, Interna klinika, Klinički centar, Kragujevac)
Đukić Aleksandar (Centar za endokrinologiju, dijabetes i bolesti metabolizma, Interna klinika, Klinički centar, Kragujevac)
Varjačić Mirjana (Ginekološko-akušerska klinika, Klinički centar, Kragujevac)
Macut Đuro (Klinika za endokrinologiju, dijabetes i bolesti metabolizma, Klinički centar Srbije, Beograd)

Introduction. Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The diagnosis of GDM is made by performing the oral glucose tolerance test (OGTT) in women with risk factors, usually during 24th to 28th week of gestation. The most common used insulin therapy regime is a conventional intensive insulin therapy with four daily doses. Objective. The aim of our study was to determine the changes in parameters of glycoregulation in GDM patients with different approach to the introduction of insulin therapy. Methods. Study group consisted of 50 pregnant women divided into two groups depending on the parameters of glycoregulation (glycemic profile and HbA1). Group 1 consisted of pregnant women initially treated with diet only and then, according to glycemic profile and HbA1 profile, in the next few weeks with insulin therapy. Group 2 were pregnant women who were treated with insulin therapy immediately after GDM diagnosis. Results. There was a statistically significant difference in mean glycemia values in the 60th and 120th minute between the two groups (p=0.001). There was a difference in mean value of fasting blood and postprandial glucose between the two groups; it was higher in Group 2. There was a statistically significant difference between the two groups in HbA1c value at the beginning (5.1±0.4% vs. 5.42±0.43%, p=0.005) and at the end of therapy (4.87±0.29% vs. 5.1±0.39 %, p=0.018). Conclusion. Satisfactory glycoregulation was achieved in both studied groups.

Keywords: gestational diabetes, parameters of glycoregulation, insulin therapy