Comparative evaluation of perinatal outcomes using different treatment strategies for management of gestational diabetes mellitus
Eszhanova A.A., Beketova M.A., Rizhaev Zh.A., Agababyan L.R.
Objective. To perform comparative analysis of perinatal outcomes in pregnant women with gestational diabetes mellitus (GDM) using different treatment strategies (nutrition therapy versus insulin therapy) and to identify the presence or absence of statistically significant differences depending on the time to start therapy.
Materials and methods. A retrospective cohort study was carried out in 2024–2025. The cohort for targeted therapy was comprised of 300 pregnant women with laboratory confirmed diagnosis of GDM. Based on treatment strategy, the patients were divided into 2 group. Group 1 (nutrition therapy) consisted of 180 patients, in whom carbohydrate metabolism compensation was achieved through nutrition therapy and physical exercise. Group 2 (insulin therapy) consisted of 120 patients, who were prescribed basal-bolus insulin regimen due to ineffectiveness of nutritional intervention. The following parameters were assessed: time to diagnosis and initiation of insulin therapy, mode of delivery, anthropometric data of newborns (weight, the presence of macrosomia), Apgar scores at 1 and 5 minutes, and the frequency of transferring newborns to NICU.
Results. It was found that therapy was initiated on average at 32.27±2.67 weeks of gestation. Cesarean delivery rate was high in both groups – 71.1% (128/180) in the group receiving nutrition therapy, and 64.2% (77/120) (p=0.335) in the group receiving insulin therapy. In the insulin therapy group, the newborns needed to be transferred to NICU significantly more often – 15/120 (12.5%) versus 10/180 (5.6%) in the nutrition therapy group (p=0.028). No statistically significant differences were found in the occurrence of macrosomia – 17/120 (14.2%) versus 25/180 (13.9%), and in Apgar scores.
Conclusion. High frequency of neonatal complications (transfer to NICU) was observed in the insulin therapy group, that was initiated in the third trimester of pregnancy, compared with the diet therapy group.
Authors' contributions. Eszhanova A.A. – the study concept, data collection and statistical data processing, manuscript writing; Beketova M.A. – scientific consulting, statistical data processing, manuscript writing; Rizhaev Zh.A. – managing the research process, choice of research methods, scientific editing; Agababyan L.R. – scientific consulting, validation of the results, final approval of the manuscript.
Conflicts of interest. The authors confirm that they have no conflict of interest to declare. Comparative analysis of the effectiveness of insulin medications was not funded by pharmaceutical companies.
Funding. The study was carried out at the Department of Obstetrics and Gynecology No.2, Astana Medical University, within the framework of a PhD dissertation without any external funding.
Ethical Approval. The study was approved by the local Ethics Committee of multidisciplinary city hospital No.2, Astana (protocol No. 5 of February 13, 2026).
Generative Artificial Intelligence. No generative AI was used in preparing this article.
Patient Consent for Publication. The patients have signed informed consent for publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Eszhanova A.A., Beketova M.A., Rizhaev Zh.A., Agababyan L.R. Comparative evaluation of perinatal outcomes using different treatment strategies for management of gestational diabetes mellitus.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (7): 66-71 (in Russian)
https://dx.doi.org/10.18565/aig.2026.65
Keywords
gestational diabetes mellitus
insulin therapy
diet therapy
macrosomia
neonatal outcomes
late therapy initiation
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Received 24.02.2026
Accepted 26.06.2026
About the Authors
Aliya A. Eszhanova, Teaching Assistant at the Department of Obstetrics and Gynecology No. 2, NAO «Astana Medical University», 010000, Kazakhstan, Astana,Ryskulova str., 8, +77015476982, eszhanova.a@amu.kz, https://orcid.org/0009-0002-6770-390X
Makpal A. Beketova, Master of Science in Medicine, Teaching Assistant at the Department of Obstetrics and Gynecology No. 2, NAO «Astana Medical University»,
010000, Kazakhstan, Astana, Ryskulova str., 8, +7 771 371 0186, makpal.beketova0807@gmail.com, https://orcid.org/0000-0003-3014-0170
Jasur A. Rizaev, Dr. Med. Sci., Professor, Rector, Samarkand State Medical University, 140100, Uzbekistan, Samarkand, Amir Temur str., 18, +998954197899,
dr.jasur@gmail.com, https://orcid.org/0000-0001-5468-9403
Larisa R. Agababyan, PhD, Professor, Head of the Department of Obstetrics and Gynecology with the Course of Neonatology, Faculty of Postgraduate Education,
140100, Uzbekistan, Samarkand, Amir Temur str., 18, +998954197899, larisa_mct@yahoo.com, https://orcid.org/0000-0003-3011-6998
Corresponding author: Aliya A. Eszhanova, a.eszhanova@list.ru
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