Evidence map›Paper›PMID 34579668›Full record

ArticleBMC pregnancy and childbirth2021

The effects of insulin therapy on maternal blood pressure and weight in women with gestational diabetes mellitus.

Tiange Sun, Fanhua Meng, Shufei Zang, Yue Li, Rui Zhang, Zhiyan Yu, Xinmei Huang, Fang Wang, Liwen Zhang, Jun Liu

Open access · goldAbstract read
In one paragraph

Article in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Gestational weight gain according to treatment in gestational diabetes: a systematic review and meta-analysis.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2025
    Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Tiange Sun *Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, 200240, Shanghai, China.
Fanhua Meng *Department of Radiology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, 200240, Shanghai, China.
Shufei ZangDepartment of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, 200240, Shanghai, China.
Yue LiDepartment of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, 200240, Shanghai, China.
Rui ZhangDepartment of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, 200240, Shanghai, China.
Zhiyan YuDepartment of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, 200240, Shanghai, China.
Xinmei HuangDepartment of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, 200240, Shanghai, China.
Fang WangDepartment of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, 200240, Shanghai, China. fangwang313@163.com.
Liwen ZhangDepartment of Obstetrics and Gynecology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, 200240, Shanghai, China. 13321837079@163.com.
Jun LiuDepartment of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqin Road, 200240, Shanghai, China. liujun@5thhospital.com.
Fudan University · CN

Funding

key medical specialty funded by shanghai fifth people's hospital, fudan university 2018WYZD004scientific and innovative action plan of shanghai 21S31901800Shanghai Municipal Health Commission Foundation 202040386the medical key faculty foundation of shanghai ZK2019B15The Shanghai Plan for Women and Children's Health Service Capacity Construction The Shanghai Plan for Women and Children's Health Service Capacity Construction
6 · The paper itself

Abstract

backgroundAlthough insulin therapy achieves effective glycemic control, it may aggravate hyperinsulinemia. Nonetheless the benefits of insulin as first-line treatment for women with GDM are controversial. This work aimed to investigate the effect of insulin on maternal GDM.

methodsThis retrospective cohort study recruited 708 women with GDM of whom 616 underwent lifestyle intervention and 92 were prescribed insulin therapy. Differences in variables between the two groups were analyzed by univariate analysis and multivariate analysis. Propensity score matching was used to control for age, pre-pregnancy BMI, time and BP at GDM diagnosis, and family history of diabetes and hypertension. Paired sample test was applied to evaluate the changes in BP after intervention in the two groups of women.

resultsThere was no significant difference in mode of delivery, newborn weight or incidence of macrosomia between women prescribed insulin and those who adopted lifestyle modifications. Insulin therapy was associated with a slight increase in maternal weight compared with the lifestyle intervention group and was attributed to short-term treatment (about 12 weeks). In addition, insulin therapy remarkably increased maternal blood pressure, an effect that persisted after matching age, pre-pregnancy BMI, time and BP at GDM diagnosis, and family history of diabetes and hypertension. Between commencing insulin therapy and delivery, systolic blood pressure significantly increased by 6mmHg (P = 0.015) and diastolic blood pressure by 9 mmHg (P < 0.001). Increase in BP was significantly higher in the insulin group compared with the lifestyle intervention group (P < 0.001). Logistic regression analysis with enter selection confirmed that insulin therapy was closely correlated with development of gestational hypertension (GH).

conclusionsThis work suggested that short-term insulin therapy for GDM was associated with a slight increase in maternal weight but a significant risk of increasing maternal blood pressure.

Indexed as

AdultBlood PressureBody WeightCohort StudiesDiabetes, GestationalFemaleHumansInsulinLogistic ModelsPregnancyPropensity ScoreRetrospective StudiesInsulinGestational diabetes mellitusHypertensionInsulin therapyWeight gain

Identifiers

PMID34579668
PMCPMC8474917
OpenAlexW3136793360

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.