Pregnancy Outcomes in Women with Diet-Controlled versus Insulin-Treated GDM

Open Access

Abstract

Introduction: Gestational diabetes mellitus (GDM) is one of the most frequent metabolic pregnancy disorders, involving the body's failure to regulate glucose levels adequately for the first time during pregnancy. If left untreated, it can lead to serious health problems for both the mother and the baby. This study aims to examine the differences in pregnancy results between women whose gestational diabetes was controlled by diet and those who required insulin treatment. Methods & Materials: This comparative observational study was conducted in the Department of Obstetrics and Gynecology, 250 Bedded General Hospital, Manikganj, Bangladesh, from January to December 2025. A total of 150 pregnant women with GDM were enrolled and categorized into diet-controlled GDM and insulin-treated GDM groups. Data were analyzed using SPSS version 26.0. Result: Out of 150 women diagnosed with GDM, 63.3% managed their glucose levels by diet, whereas 36.7% needed insulin treatment. Compared to the diet-controlled group, those on insulin were older, had a higher BMI, were diagnosed earlier, and had more deteriorated blood sugar levels. Besides, they displayed greatly elevated maternal problems such as preeclampsia (21.8% vs. 9.5%), preterm births (25.5% vs. 11.6%), and cesarean operations (54.5% vs. 33.7%). Newborn health was adversely affected in the insulin recipients as shown by greater birth size (3.36 vs. 3.02 kg), macrosomic infants (21.8% vs. 8.4%), newborn hypoglycemia (25.5% vs. 6.3%), NICU admissions (32.7% vs. 12.6%), and respiratory distress (23.6% vs. 7.4%). Conclusion: Women with insulin-treated GDM face substantially increased rates of negative maternal and neonatal outcomes in comparison to those who were managed with diet only. The insulin-treated women were generally older, had a higher BMI, were diagnosed earlier, and had less well-controlled blood sugar, all signs of more severe metabolic impairment.