Perinatal outcome in women with gestational diabetes mellitus treated with Gensulin or regular human insulin during pregnancy

Abstract

INTRODUCTION. Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance with variable severity with onset or first recognition during pregnancy. It develops during pregnancy as a consequence of physiological insulin resistence, that is caused by increased production of several diabetogenic hormones and is followed by maternal hyperglycemia that reflects a continuum of risk for adverse outcomes including neonatal morbidities such as macrosomia, birth trauma and neonatal hypoglycemia. Untreated GDM is associated with increased adverse outcome in pregnancy and the treatment results in perinatal outcome comparable to the general population. Aim of the study was to evaluate metabolic control and obstetrical results in the group of pregnant women with GDM treated with Polish human insulin (Gensulin).
MATERIAL AND METHODS. The study group consisted of 60 GDM pregnant women who required insulin treatment. Thirty of them were treated with Gensulin, and remaining 30 were treated with other human insulins. Insulin was introduced when despite the restricted diet, fasting glucose levels exceeded 5.3 mmol/l and 2-h postprandial levels exceeded 6.7 mmol/l. In both groups maternal age and prepregnancy body weight were analyzed. Weight gain during pregnancy, glucose metabolism and insulin requirement at the beginning of treatment and before delivery were also studied. At the last step of the study neonatal weight and condition were analyzed.
RESULTS. No difference in maternal age as well as in pre pregnancy weight was noticed between analyzed groups. In both groups sufficient metabolic control was achieved, by using similar insulin doses. Mean neonatal weight didn’t differ between both analyzed groups, however percentage of newborns with LGA was significantly lower in the group treated with lower Gensulin.
CONCLUSION. Treatment with Gensulin as well as with other human insulins enables proper management during pregnancy complicated with GDM and gives the chance for successful fetal outcome.