RESULTS
Overall, 301 women were enrolled, of them, 143 women in the study group and 158 in the control group. The groups were similar with regard to demographic and clinical characteristics, including age, parity, and pre-pregnancy body mass index (BMI) (Table 1). Both groups were similar in the parameters considered as risk factors for insulin resistance and GDM, such as gestational weight gain, previous GDM, diabetes among first-degree relatives, glucose values during the first trimester, and GCT result.
The rate of suboptimal glucose control was higher in the study group (14% vs. 5.1% in comparison to the control group, P =.01) (Table 2). There was no significant group difference in the need for insulin treatment to achieve desired levels of glycemic control after dietary adjustment and enhanced physical activity. Other secondary outcome measures, such as birthweight, mode of delivery, and prevalence of hyperglycemia-related complications (polyhydramnios, macrosomia) were also similar between the study groups (Table 2).
A multiple logistic regression analysis showed that a low glucose value of 100 gr at 3 hours was associated with a higher incidence of suboptimal glucose control (odds ratio 3.1, confidence interval [CI] 1.35-7.83, P =.01). The effects of factors that are traditionally considered predictors of insulin resistance on suboptimal daily glucose profile, such as BMI, first trimester fasting glucose, and weight gain, did not reach a level of significance (Fig. 1).