Endocrine Abstracts

Introduction: Gestational Diabetes Mellitus (GDM) is a pregnancy complication that has experienced a worldwide growth. The use of insulin has to be considered as it may be beneficial for both the mother and the new-born.

Methods: Retrospective analysis of all cases of GDM, and the respective new-borns (NB), followed in our obstetrics unit between 2012 and 2015. Clinical and workup parameters were evaluated in 2 groups: GDM with no insulin therapy (GDMNIT) and GDM with insulin therapy (GDMIT). Data analysed using SPSSv23.0.

Results: We studied 644 GDM and 35% of them were treated with insulin. The BMI was significantly higher in GDMIT (P<0.001). Induced labour occurred in 36% of GDMNIT and in 40% of GDMIT, with statistically significant difference (P=0.027). The number of C-sections was superior in GDMIT (41 vs 36%), but without significant difference. The need for hospitalization of the NB in the Neonatal Intensive Care Unit (NICU) was significantly higher in GDMNIT. The NB weigh (Fenton) was also significantly different between both group (P=0.019), with “large for gestacional age” being higher in GDMIT (7 vs 3%). Postpartum positive screening for Diabetes Mellitus was 0% in GDMNIT and 2% in GDMIT.

Conclusions: One of the indications for induced labour is GDMIT because of the higher risk of fetal complications, which was verified in this study. As the literature states, GDMIT is associated with a difficult blood sugar control during pregnancy. This means that an unsuccessful maintenance of euglycemia may be associated to heavier NB and eventual peripartum complications. However, GDMNIT was associated with more hospitalizations in NICU, and the main causes were prematurity, hyperbilirubinemia and acute respiratory distress syndrome. The results of postpartum screening are in accordance with the literature.