Endocrine Abstracts

Introduction: Gestational diabetes mellitus (GDM) complicates approximately 3% to 9% of pregnancies. Diagnosis and treatment of GDM remain essential to limit maternal and neonatal outcomes. The aim of the study was to evaluate the difference in pregnancy outcomes between insulin- and diet-treated tunisian women with gestational diabetes.

Methods: It was a prospective longitudinal study including 220 patients followed for GDM at the research unit of the C department of the national institute of nutrition in Tunis. The patients were followed during pregnancy and until post partum. Patients were divided into two groups: group 1 (G1): Insulin treated and insulin therapy and group 2 (G2): Patients treated by diet alone.

Results: At the end of our study, 68 patients were treated with insulin, 11 patients developed gestational hypertension or pre-eclampsia. Two thirds of the patients (68%) delivered by cesarean section. Neonatal outcomes were dominated by macrosomia (13.5%) and transient respiratory distress (11.4%). insulin-treated patients had a higher incidence of gestational hypertension (G1: 11.9% vs G2: 2.1%;P=0.03). insulin treatement did not reduces the rate of caesarean section (G1: 64.7% vs G2: 63.2%;P=0.785). Insulin therapy did not reduce fetal outcomes, including intrauterine growth retardation (G1: 0% vs G2: 1.3%;P=0.326), fetal death in utero (G1: 0% vs G2: 1.3%;P=0.306), neonatal hypoglycemia (G1: 0% vs G2: 1.3%;P=0.333), macrosomia (G1: 17.6% vs G2: 11.2%;P=0.203), hydramnios (G1: 13.2% vs G2: 6.6%;P=0.111), transient respiratory distress (G1: 11.8% vs G2: 10.5%;P=0.781), neonatal jaundice (G1: 5.9% vs G2: 3.3%;P=0.787) and prematurity (G1: 7.4% vs G2: 4.6%;P=0.452).

Conclsion: Our study showed that patients treated with insulin had a higher incidence of pregnancy induced-hypertension. However, treatment of gestational diabetes with insulin did not reduces the rate of caesarean section and noenatal morbidity.