Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitus
| Autor: | Jean Carl Silva, Thiago Ribeiro e Silva, Iramar Baptistella do Nascimento, Matheus Leite Ramos de Souza, Larissa Cano de Oliveira, Rodrigo Ribeiro e Silva, Guilherme Dienstmann |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Blood Glucose medicine.medical_specialty insulin medicine.medical_treatment 030209 endocrinology & metabolism Obesity Maternal 03 medical and health sciences 0302 clinical medicine Pregnancy Diabetes mellitus Internal medicine medicine Humans Hypoglycemic Agents combined treatment Glycemic 030219 obstetrics & reproductive medicine business.industry Insulin Case-control study Obstetrics and Gynecology Gynecology and obstetrics Odds ratio medicine.disease Exercise Therapy Metformin Gestational diabetes Diabetes Gestational Parity Case-Control Studies RG1-991 Drug Therapy Combination Female gestational diabetes business metformin medicine.drug |
| Zdroj: | Revista Brasileira de Ginecologia e Obstetrícia v.41 n.12 2019 Revista brasileira de ginecologia e obstetrícia Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO) instacron:FEBRASGO Revista Brasileira de Ginecologia e Obstetrícia, Vol 41, Iss 12, Pp 697-702 (2020) |
| Popis: | To evaluate the factors associated with the need for insulin as a complementary treatment to metformin in pregnant women with gestational diabetes mellitus (GDM). A case-control study was performed from April 2011 to February 2016 with pregnant women with GDM who needed complementary treatments besides diet and physical exercise. Those treated with metformin were compared with those who, in addition to metformin, also needed the combination with insulin. Maternal characteristics and glycemic control were evaluated. Multinomial logistic regression models were developed to evaluate the influence of different therapies on neonatal outcomes. A total of 475 pregnant women who needed pharmacological therapy were evaluated. Of these, 366 (77.05%) were submitted to single therapy with metformin, and 109 (22.94%) needed insulin as a complementary treatment. In the analysis of the odds ratio (OR), fasting glucose (FG) 90 mg/dL reduced the odds of needing the combination (OR: 0.438 [0.235-0.815]; Obesity resulted in an increased chance of the mother needing insulin as a complementary treatment to metformin, while FG 90 mg/dL and primiparity were protective factors. Avaliar os fatores associados à necessidade de insulina como tratamento complementar à metformina em gestantes com diabetes mellitus gestacional (DMG). MéTODOS: Um estudo caso-controle foi realizado de abril de 2011 a fevereiro de 2016 com gestantes portadoras de DMG que necessitaram de tratamentos complementares além de dieta e exercícios físicos. Aquelas tratadas com metformina foram comparadas com aquelas que, além da metformina, também precisaram de combinação com insulina. Foram avaliadas as características maternas e de controle glicêmico. Modelos de regressão logística multinomial foram construídos para avaliar a influência das diferentes terapias nos desfechos neonatais. Foram avaliadas 475 gestantes que necessitaram de terapia farmacológica. Destas, 366 (77,05%) utilizaram terapia única com metformina, e 109 (22,95%) necessitaram de insulina como tratamento complementar. Na análise da razão de possibilidades (RP), a glicemia de jejum (GJ) 90 mg/dL reduziu as chances de necessidade da combinação (RP: 0,438 [0,235–0,815] |
| Databáze: | OpenAIRE |
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