Influence of nutritional status and gestational weight gain on insulin therapy among women with Gestational Diabetes Mellitus: a retrospective analysis

Abstract

Objectives:  to investigate the relation between insulin use, pregestational nutritional status, and maternal weight gain during pregnancy among women with gestational diabetes mellitus.

Methods:  a retrospective cross-sectional study (2017-2022) was conducted with data from women followed at a University hospital in the Southeast of Brazil. Maternal weight gain adequacy was assessed according to new curves proposed for Brazilian pregnant women. Pregestational nutritional status, age, height, race, schooling, marital status, residence, parity, number of pregnancies and abortions, fasting glucose, and hypertensive disorders were analyzed. The use of insulin was considered the outcome in a multiple logistic regression model, using as reference, the categories least associated with gestational diabetes mellitus.

Results:  among the 353 participants, 48.7% were obese and 47.4% required insulin. Obese women were more likely to use insulin (OR= 2.26; 95%CI= 1.16-4.41; p=0.003). Regarding to weight gain, eutrophic women with above-adequate gain had greater odds of insulin use (OR= 3.22; 95%CI= 1.15-9.05; p=0.024). Conversely, among those with adequate or below-adequate gain, obese women showed higher chances of needing insulin (OR= 4.33; 95%CI= 1.76-10.6; p=0.001).

Conclusion:  the findings reinforce the necessity for specific guidelines on gestational weight gain for women with gestational diabetes mellitus, considering differences in both nutritional status and weight gain patterns throughout pregnancy.

key words
Maternal weight gain; Gestational diabetes mellitus; Insulin therapy