Outcomes comparison of gestational diabetes diagnosed in the first and second trimesters of pregnancy

Abstract

Study aim: to evaluate the outcomes of early and late gestational diabetes (GD) for the mother, fetus, and newborn. Research methods: we conducted a prospective study at Vilnius University Hospital Santaros Clinics (VUHSC), 242 women were included in the 24-28th week of pregnancy. We evaluated anthropometric data and risk factors for gestational diabetes. Women with GD were divided into two groups: 1) early GD (n=163) and 2) late GD (n=79). Weight gain during pregnancy, treatment of gestational diabetes with only diet or insulin, biochemical tests, birth outcomes, and newborn data were compared between the first and second groups of women. Statistical analysis was performed using Microsoft Excel data analysis tools. Results: women in the early GD group have higher BMI before pregnancy, higher HOMA-IR index during pregnancy, and are more often treated with insulin, the newborns in this group are born heavier as well. The incidence of macrosomia was not statistically significant between groups.

Conclusions:  Our study demonstrates that early GD (fasting plasma glycemia ≥5.1 mmol/L before the 24th week of gestation) is associated with higher prepregnancy BMI, insulin resistance, and higher birth weight, with no significant effects on preterm birth, cesarean section rates, or neonatal hypoglycemia. Nevertheless, patients with early GD more often require insulin treatment and management of hyperglycemia with insulin therapy undoubtedly improves the gestational outcomes.