{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T09:59:45Z","timestamp":1771581585701,"version":"3.50.1"},"reference-count":47,"publisher":"Georg Thieme Verlag KG","issue":"01","funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["K24DK093699"],"award-info":[{"award-number":["K24DK093699"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK118038"],"award-info":[{"award-number":["R01DK118038"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK120861"],"award-info":[{"award-number":["R01DK120861"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["PI: Egede"],"award-info":[{"award-number":["PI: Egede"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006545","name":"National Institute for Minority Health and Health Disparities","doi-asserted-by":"crossref","award":["R01MD013826"],"award-info":[{"award-number":["R01MD013826"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006545","name":"National Institute for Minority Health and Health Disparities","doi-asserted-by":"crossref","award":["PI: Egede\/Walker"],"award-info":[{"award-number":["PI: Egede\/Walker"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000041","name":"American Diabetes Association","doi-asserted-by":"crossref","award":["1-19-JDF-075"],"award-info":[{"award-number":["1-19-JDF-075"]}],"id":[{"id":"10.13039\/100000041","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000041","name":"American Diabetes Association","doi-asserted-by":"crossref","award":["PI: Walker"],"award-info":[{"award-number":["PI: Walker"]}],"id":[{"id":"10.13039\/100000041","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>\n            Objective\u2003The aim of this study was to investigate prenatal factors associated with insulin prescription as a first-line pharmacotherapy for gestational diabetes mellitus (GDM; compared with oral antidiabetic medication) after failed medical nutrition therapy.<\/jats:p><jats:p>\n            Study Design\u2003This is a retrospective cohort study of 437 women with a singleton pregnancy and diagnosis of A2GDM (GDM requiring pharmacotherapy), delivering in a university hospital between 2015 and 2019. Maternal sociodemographic and clinical characteristics, as well as GDM-related factors, including provider type that manages GDM, were compared between women who received insulin versus oral antidiabetic medication (metformin or glyburide) as the first-line pharmacotherapy using univariable and multivariable analyses.<\/jats:p><jats:p>\n            Results\u2003In univariable analysis, maternal age, race and ethnicity, insurance, chronic hypertension, gestational age at GDM diagnosis, glucose level after 50-g glucose loading test, and provider type were associated with insulin prescription. In multivariable analysis, after adjusting for sociodemographic and clinical maternal factors, GDM characteristics and provider type, Hispanic ethnicity (0.26, 95% confidence interval [CI]: 0.09\u20130.73), and lack of insurance (0.34, 95% CI: 0.13\u20130.89) remained associated with lower odds of insulin prescription, whereas endocrinology management of GDM (compared with obstetrics and gynecology [OBGYN]) (8.07, 95% CI: 3.27\u201319.90) remained associated with higher odds of insulin prescription.<\/jats:p><jats:p>\n            Conclusion\u2003Women of Hispanic ethnicity and women with no insurance were less likely to receive insulin and more likely to receive oral antidiabetic medication for GDM pharmacotherapy, while management by endocrinology was associated with higher odds of insulin prescription.<\/jats:p><jats:p>This finding deserves more investigation to understand if differences are due to patient choice or a health disparity in the choice of pharmacologic agent for A2GDM.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1739266","type":"journal-article","created":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T23:46:55Z","timestamp":1636588015000},"page":"008-015","source":"Crossref","is-referenced-by-count":5,"title":["Correlates of Insulin Selection as a First-Line Pharmacological Treatment for Gestational Diabetes"],"prefix":"10.1055","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6568-0201","authenticated-orcid":false,"given":"Anna","family":"Palatnik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin"},{"name":"Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel K.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhuli Y.","family":"Thakkar","sequence":"additional","affiliation":[{"name":"Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebekah J.","family":"Walker","sequence":"additional","affiliation":[{"name":"Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin"},{"name":"Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard E.","family":"Egede","sequence":"additional","affiliation":[{"name":"Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin"},{"name":"Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,11,10]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.diabres.2013.11.003","article-title":"Global estimates of the prevalence of hyperglycaemia in pregnancy","volume":"103","author":"L Guariguata","year":"2014","journal-title":"Diabetes Res Clin Pract"},{"issue":"19","key":"ref2","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1056\/NEJMoa0707943","article-title":"Hyperglycemia and adverse pregnancy outcomes","volume":"358","author":"B E Metzger","year":"2008","journal-title":"N Engl J Med"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1097\/AOG.0000000000002501","article-title":"ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus","volume":"131","year":"2018","journal-title":"Obstet 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