Weight gain in gestational diabetes: the effect of treatment modality

To evaluate treatment effectiveness (diet alone, insulin or glyburide) on maternal weight gain in gestational diabetes (GDM).

GDM patients were treated with diet alone, insulin or glyburide. Weight gain was stratified into: prior to GDM diagnosis, from diagnosis to delivery and total pregnancy weight gain. Good glycemic control was defined as mean blood glucose ≤ 105 mg/dl and obesity as Body Mass Index (BMI) ≥ 30 kg/m(2), overweight BMI 25-29 kg/m(2) and normal < 25 kg/m(2).

Total weight gain was similar in all the treatment groups. Two-thirds of weight gain occurred prior to diagnosis (diet 85%, insulin 67% and glyburide 78%). Post-diagnosis, patients on diet alone gained less weight than those on insulin or glyburide (p < 0.001); insulin-treated patients showed greater weight gain than glyburide-treated patients (p < 0.001). Patients on diet with good glycemic control showed less weight gain after diagnosis than patients on insulin or glyburide (2.8 ± 13, 6.6 ± 10, 5.2 ± 7.9 lbs, respectively, p < 0.02). Poorly-controlled patients, regardless of treatment, had similar patterns of weight gain throughout pregnancy.

Patterns of maternal weight gain in GDM pregnancies are associated with treatment modality and level of glycemic control.