Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitus
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista brasileira de ginecologia e obstetrícia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032019001200697 |
Resumo: | Abstract Objective To evaluate the factors associated with the need for insulin as a complementary treatment to metformin in pregnant women with gestational diabetes mellitus (GDM). Methods 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. Results 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]; p=0.009], as well as primiparity (OR: 0.280 [0.111-0.704]; p=0.007]. In obese pregnant women, an increased chance of needing the combination was observed (OR: 2,072 [1,063-4,039]; p=0,032). Conclusion 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. |
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Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitusgestational diabetesmetformininsulincombined treatmentAbstract Objective To evaluate the factors associated with the need for insulin as a complementary treatment to metformin in pregnant women with gestational diabetes mellitus (GDM). Methods 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. Results 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]; p=0.009], as well as primiparity (OR: 0.280 [0.111-0.704]; p=0.007]. In obese pregnant women, an increased chance of needing the combination was observed (OR: 2,072 [1,063-4,039]; p=0,032). Conclusion 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.Federação Brasileira das Sociedades de Ginecologia e Obstetrícia2019-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032019001200697Revista Brasileira de Ginecologia e Obstetrícia v.41 n.12 2019reponame:Revista brasileira de ginecologia e obstetrícia (Online)instname:Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)instacron:FEBRASGO10.1055/s-0039-1700796info:eu-repo/semantics/openAccessSouza,Matheus Leite Ramos deSilva,Rodrigo Ribeiro eSilva,Thiago Ribeiro eOliveira,Larissa Cano deDienstmann,GuilhermeNascimento,Iramar Baptistella doSilva,Jean Carleng2020-01-29T00:00:00Zoai:scielo:S0100-72032019001200697Revistahttp://www.scielo.br/rbgohttps://old.scielo.br/oai/scielo-oai.phppublicações@febrasgo.org.br||rbgo@fmrp.usp.br1806-93390100-7203opendoar:2020-01-29T00:00Revista brasileira de ginecologia e obstetrícia (Online) - Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO)false |
dc.title.none.fl_str_mv |
Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitus |
title |
Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitus |
spellingShingle |
Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitus Souza,Matheus Leite Ramos de gestational diabetes metformin insulin combined treatment |
title_short |
Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitus |
title_full |
Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitus |
title_fullStr |
Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitus |
title_full_unstemmed |
Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitus |
title_sort |
Factors Associated with the Need for Insulin as a Complementary Treatment to Metformin in Gestational Diabetes Mellitus |
author |
Souza,Matheus Leite Ramos de |
author_facet |
Souza,Matheus Leite Ramos de Silva,Rodrigo Ribeiro e Silva,Thiago Ribeiro e Oliveira,Larissa Cano de Dienstmann,Guilherme Nascimento,Iramar Baptistella do Silva,Jean Carl |
author_role |
author |
author2 |
Silva,Rodrigo Ribeiro e Silva,Thiago Ribeiro e Oliveira,Larissa Cano de Dienstmann,Guilherme Nascimento,Iramar Baptistella do Silva,Jean Carl |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Souza,Matheus Leite Ramos de Silva,Rodrigo Ribeiro e Silva,Thiago Ribeiro e Oliveira,Larissa Cano de Dienstmann,Guilherme Nascimento,Iramar Baptistella do Silva,Jean Carl |
dc.subject.por.fl_str_mv |
gestational diabetes metformin insulin combined treatment |
topic |
gestational diabetes metformin insulin combined treatment |
description |
Abstract Objective To evaluate the factors associated with the need for insulin as a complementary treatment to metformin in pregnant women with gestational diabetes mellitus (GDM). Methods 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. Results 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]; p=0.009], as well as primiparity (OR: 0.280 [0.111-0.704]; p=0.007]. In obese pregnant women, an increased chance of needing the combination was observed (OR: 2,072 [1,063-4,039]; p=0,032). Conclusion 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. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032019001200697 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032019001200697 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1055/s-0039-1700796 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Federação Brasileira das Sociedades de Ginecologia e Obstetrícia |
publisher.none.fl_str_mv |
Federação Brasileira das Sociedades de Ginecologia e Obstetrícia |
dc.source.none.fl_str_mv |
Revista Brasileira de Ginecologia e Obstetrícia v.41 n.12 2019 reponame:Revista brasileira de ginecologia e obstetrícia (Online) instname:Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO) instacron:FEBRASGO |
instname_str |
Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO) |
instacron_str |
FEBRASGO |
institution |
FEBRASGO |
reponame_str |
Revista brasileira de ginecologia e obstetrícia (Online) |
collection |
Revista brasileira de ginecologia e obstetrícia (Online) |
repository.name.fl_str_mv |
Revista brasileira de ginecologia e obstetrícia (Online) - Federação Brasileira das Sociedades de Ginecologia e Obstetrícia (FEBRASGO) |
repository.mail.fl_str_mv |
publicações@febrasgo.org.br||rbgo@fmrp.usp.br |
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1754115944953675776 |