PREGNANCY OUTCOME AS INFLUENCED BY DIETARY VERSUS INSULIN MANAGEMENT AMONG GDM MOTHERS

Background & Objectives: Gestational diabetes is a metabolic disorder characterised by carbohydrate intolerance first during pregnancy associated with foetal and maternal complications. Objectives: To assess the pregnancy outcome as influenced by dietary versus insulin management among GDM mothers Methods: A total of 102 pregnant women, visiting the antenatal clinic of Apollo Hospitals, Bangalore were recruited for the study, classified as control and GDM groups based on the blood glucose levels using IADPSG guidelines, each group consisted of 51subjects. GDM group was further classified as diet managed group (n=23) and insulin managed group (n=28) depending on the modes of management. Biochemical profile was analysed and recorded in both groups Results: Non-significantly higher term weight and a lower gestation week of delivery (37 ±1.51 weeks) and significantly higher HbA1c (6.5±1.02%) was observed in the insulin managed group when compared to the diet managed group, while, total cholesterol and triglyceride levels were significantly higher in the diet managed group (p<0.03 and 0.007) respectively. Caesarean section was common in both groups. The mean birth weight of the infants in both groups was comparable (2.9±0.3 and 2.8±0.52 kg). Whereas, significantly higher serum bilirubin levels were observed in infants born to insulin managed women (9 ±4.78 mg/dl), indicating a poor morbidity status in these infants. Interpretation & Conclusion: Medical nutrition therapy and insulin initiation are the two modes of blood glucose management in GDMs which aids in preventing complications and influencing near to normal pregnancy outcome.