Individual Prediction of Insulin Therapy in Gestational Diabetes: Development of
a Risk Calculator Based on Real-World Data from the GestDiab Registry
#MMPMID41347058
Weschenfelder F
; Dusek B
; Adamczewski H
; Weber D
; Kaltheuner M
; Heimann Y
; Groten T
Geburtshilfe Frauenheilkd
2025[Dec]; 85
(12
): 1334-1341
PMID41347058
show ga
INTRODUCTION: The prevalence of gestational diabetes mellitus in Germany is
approximately 10%. One third of affected women require insulin therapy when
conservative measures such as dietary changes and physical activity are
insufficient to achieve target glucose levels. Timely initiation of insulin
therapy is crucial for optimising obstetric outcomes. Early identification of
high-risk patients at the time of diagnosis would facilitate prompt and
individualised treatment adjustments. MATERIALS AND METHODS: A risk calculator
was developed based on clinical parameters and medical history information to
estimate the individual risk for insulin therapy. The models were derived from
real-world data of the GestDiab registry, comprising 14157 pregnancies between
2018 and 2020, of which 4319 (30.5%) required insulin therapy. RESULTS: Various
models incorporating maternal age, gestational age at diagnosis, parity,
gravidity, body mass index, 75 g oral glucose tolerance test values, HbA1c
levels, history of gestational diabetes mellitus, and family history of diabetes
were developed. Validation using the GestDiab cohort from 2021 demonstrated that
the model including all variables exhibited the highest predictive power
(AUC 0.740). CONCLUSIONS: The risk calculator is provided online to support both
patients and physicians in making informed decisions. Individualised counselling
based on personal risk assessments may enhance therapy adherence and potentially
reduce the necessity for insulin therapy.
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