Glucose Disposal Index Predicts Adverse Pregnancy Outcomes in Gestational Diabetes

To explore the prognostic significance of the Glucose Disposal Index (DI) concerning unfavorable pregnancy outcomes in mothers and newborns affected by Gestational Diabetes Mellitus (GDM).

Our investigation encompassed 75 GDM patients who received treatment at Anhui Mingguang People's Hospital between January 2019 and July 2023. Subjects were divided into two groups: those with adverse pregnancy outcomes (n = 18) and those without (n = 57). Between weeks 24 and 28 of gestation, all participants underwent a 75 g Oral Glucose Tolerance Test (OGTT), and relevant details such as height, weight, and complete pregnancy information were gathered. The Insulin Sensitivity Index (ISI) and the area beneath the insulin-to-glucose curve from 0 to 120 minutes (AUC_INS120/AUC_GLU120) were computed from the 75 g OGTT findings, and their multiplication was represented as DI. Comparisons between groups were made using t tests, Wilcoxon rank-sum tests, and χ2 tests. Binary logistic regression was applied to probe the relationship between DI and the risk of adverse pregnancy outcomes, and the Receiver Operating Characteristic (ROC) curve was employed to evaluate the predictive capacity of DI.

Statistically meaningful differences in FPG, HbA1c, and DI were noted between the groups (P < .05), whereas the difference in 2hPG was not significant (P > .05). Pearson correlation analysis revealed a negative correlation between DI and both FPG and HbA1c (P < .05). Multivariate logistic regression showed that DI (OR = 0.599) was a determining factor of adverse pregnancy outcomes (P < .05). The ROC curve disclosed an AUC of 0.837 for DI in forecasting adverse pregnancy outcomes (95% CI: 0.741-0.933), with a specificity of 82.10% and a sensitivity of 80.65% at the optimal threshold value of 2.1.

An elevation in DI among GDM patients is closely linked to a reduced risk of adverse pregnancy outcomes, corroborating DI's prognostic value for such outcomes in gestational diabetes.