One-hour post-glucola results and pre-pregnancy body mass index are associated with the need for insulin therapy in women with gestational diabetes.

Objective. The purpose of this study was to analyze the relationship of 1-h post-glucola (PG) screening results and the need for insulin therapy in women with gestational diabetes (GDM). Methods. The study group was comprised of women with GDM treated at a single institution during calendar years 2000-2004. Women with singleton, term (>= 37 weeks gestation), liveborn fetuses were included. The association of 1-h PG results and other perinatal risk factors to the need for subsequent insulin therapy was analyzed using multivariable logistic regression models. Results. Of the 1451 women were included in the analysis, 18.1% required insulin treatment. The mean 1-h PG result was 170.0+/-26.1 mg/dl (range 140-414 mg/dl). We determined that a 1-h PG >= 190 mg/dl (p < 0.0001), an obese body mass index (BMI) (p < 0.0001), an overweight BMI (p = 0.0019), prior GDM (p = 0.0019), and prior macrosomia (p = 0.0210) were each highly associated with the need for subsequent insulin therapy during the pregnancy. Conclusions. A 1-h PG >= 190 mg/dl was strongly associated with the need for insulin therapy in women with GDM. These data may be helpful in counseling and managing women with GDM.