TREATMENT PATTERNS AND PREGNANCY OUTCOMES IN GESTATIONAL DIABETES: A SOUTH INDIAN PROSPECTIVE COHORT STUDY

Abstract

Background: Gestational Diabetes Mellitus (GDM) poses significant risks to both maternal and neonatal health. This study evaluated and compared glycemic and perinatal outcomes across treatment modalities, including pharmacological therapies (insulin and metformin), lifestyle interventions (diet and physical activity), and combinations thereof. Methods: A prospective cohort study was conducted at a tertiary care hospital in South India involving 200 pregnant women with GDM. Participants were divided into five groups: G1 (lifestyle only), G2 (metformin), G3 (insulin only), G4 (metformin + lifestyle), and G5 (insulin + lifestyle). Fasting blood sugar (FBS) and postprandial blood sugar (PPBS) were recorded at baseline, during the second and third trimesters, and postpartum. Postpartum glucose tolerance was assessed via OGTT. Obstetric outcomes, neonatal complications, delivery mode, and NICU admissions were documented. Statistical analysis included ANOVA and post hoc tests. Results: All groups showed significant reductions in FBS and PPBS (p < 0.05), with the greatest improvements in G4 and G5. Postpartum normoglycemia was highest in G5 (88.37%) and G4 (85.11%). Maternal and neonatal complications were lowest in these combination groups, while G1 showed minimal benefit. Conclusion: Combination treatment was associated with greater improvements in glycemic measures and more favourable maternal and neonatal outcomes in this cohort; however, these findings should be interpreted in view of baseline differences between treatment groups and the nonrandomized treatment allocation.