Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram

Runyu Du, Ling Li Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of ChinaCorrespondence: Ling LiDepartment of Endocrinology, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District,...

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Autores principales:	Du R, Li L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	pregnancy glycemic control insulin therapy prediction Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/7fcc5102b36e48dabfcd010fc31fb165
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spelling	oai:doaj.org-article:7fcc5102b36e48dabfcd010fc31fb1652021-12-02T15:50:41ZEstimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram1178-7007https://doaj.org/article/7fcc5102b36e48dabfcd010fc31fb1652021-06-01T00:00:00Zhttps://www.dovepress.com/estimating-the-risk-of-insulin-requirement-in-women-complicated-by-ges-peer-reviewed-fulltext-article-DMSOhttps://doaj.org/toc/1178-7007Runyu Du, Ling Li Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of ChinaCorrespondence: Ling LiDepartment of Endocrinology, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, Liaoning Province, 110004, People’s Republic of ChinaTel +86 18940251181Fax +86 24-25944460Email liling8864@hotmail.comPurpose: This study sought to develop a nomogram for the prediction of insulin requirement in a Chinese population with gestational diabetes mellitus (GDM).Materials and Methods: We performed a retrospective cohort study involving 626 Chinese women with GDM, of whom 188 were treated with insulin. “Least absolute shrinkage and selection operator” regression was used to optimize the independent predictors of insulin requirement during pregnancies complicated with GDM. Cox proportional hazards regression analysis was performed to establish a prediction model incorporating the selected predictors, and the nomogram was constructed to achieve individual prediction. The C-index, calibration plot and decision curve analysis were used to validate the model.Results: Maternal age, family history of type 2 diabetes mellitus in a first-degree relative, a prior GDM history, fasting plasma glucose, hemoglobin A1c, gestational age, and body mass index values at the time of GDM diagnosis were the risk factors for insulin treatment. The model displayed medium predictive power with a C-index of 0.77 (95% confidence interval: 0.73– 0.81) and relatively good calibration accuracies. The decision curve demonstrated a positive net benefit with a threshold between 0.09 and 0.70.Conclusion: The findings suggest that our nomogram, incorporating seven indicators, is useful in predicting individualized survival probabilities of insulin requirement.Keywords: pregnancy, glycemic control, insulin therapy, predictionDu RLi LDove Medical Pressarticlepregnancyglycemic controlinsulin therapypredictionSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 14, Pp 2473-2482 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pregnancy glycemic control insulin therapy prediction Specialties of internal medicine RC581-951
spellingShingle	pregnancy glycemic control insulin therapy prediction Specialties of internal medicine RC581-951 Du R Li L Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram
description	Runyu Du, Ling Li Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of ChinaCorrespondence: Ling LiDepartment of Endocrinology, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, Liaoning Province, 110004, People’s Republic of ChinaTel +86 18940251181Fax +86 24-25944460Email liling8864@hotmail.comPurpose: This study sought to develop a nomogram for the prediction of insulin requirement in a Chinese population with gestational diabetes mellitus (GDM).Materials and Methods: We performed a retrospective cohort study involving 626 Chinese women with GDM, of whom 188 were treated with insulin. “Least absolute shrinkage and selection operator” regression was used to optimize the independent predictors of insulin requirement during pregnancies complicated with GDM. Cox proportional hazards regression analysis was performed to establish a prediction model incorporating the selected predictors, and the nomogram was constructed to achieve individual prediction. The C-index, calibration plot and decision curve analysis were used to validate the model.Results: Maternal age, family history of type 2 diabetes mellitus in a first-degree relative, a prior GDM history, fasting plasma glucose, hemoglobin A1c, gestational age, and body mass index values at the time of GDM diagnosis were the risk factors for insulin treatment. The model displayed medium predictive power with a C-index of 0.77 (95% confidence interval: 0.73– 0.81) and relatively good calibration accuracies. The decision curve demonstrated a positive net benefit with a threshold between 0.09 and 0.70.Conclusion: The findings suggest that our nomogram, incorporating seven indicators, is useful in predicting individualized survival probabilities of insulin requirement.Keywords: pregnancy, glycemic control, insulin therapy, prediction
format	article
author	Du R Li L
author_facet	Du R Li L
author_sort	Du R
title	Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram
title_short	Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram
title_full	Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram
title_fullStr	Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram
title_full_unstemmed	Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram
title_sort	estimating the risk of insulin requirement in women complicated by gestational diabetes mellitus: a clinical nomogram
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/7fcc5102b36e48dabfcd010fc31fb165
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Estimating the Risk of Insulin Requirement in Women Complicated by Gestational Diabetes Mellitus: A Clinical Nomogram

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