Virginia Via Research Day Book 2026

Medical Student Research Clinical

19 GESTATIONAL DIABETES MELLITUS VS PRE-GESTATIONAL DIABETES AND PRE-ECLAMPSIA: A RETROSPECTIVE STUDY COMPARING THE RATE OF PRE-ECLAMPSIA IN INSULIN TREATED AND DIET CONTROLLED PATIENTS

Ciera Miller, OMS-III; Nicole Muhlenbruck, OMS-III Corresponding author: cmiller01@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

patients and gestational diabetes patients. Each cohort was organized into a control and experimental group. Within the pre-gestational diabetes cohort, the control group included diet-controlled patients while the experimental group included insulin-treated patients. Within the gestational diabetes cohort, the control group included gestational diabetes managed with diet (GDMA1) while the experimental group included gestational diabetes managed with insulin (GDMA2). The exclusion criteria for both of these cohorts was age below 18 and age above 34. The data collected from the All of Us Research Database was analyzed using RStudio and evaluated using statistical tests such as the chi-square test, relative risk (including a 95% confidence interval), and a Fisher’s exact test (for race comparison). This study found that there is a statistically significant association (p-value: 2.731 x 10-6) between insulin use and the development of pre-eclampsia among individuals with pre-gestational diabetes. In contrast, there is no significance (p-value: 0.2675) between

insulin use and pre-eclampsia in the gestational diabetes cohort. These results suggest that pre existing diabetes plays a role in the development of pre-eclampsia more than insulin use itself. When race was compared between these two cohort groups, there was no statistical significance in the development of pre-eclampsia for African American patients whether they were diet controlled or treated with insulin. Findings from this study suggest that pre-existing diabetes may pose more of a risk for pre-eclampsia than the use of insulin itself which supports the guideline recommendations of insulin use as the first line medical management when diet-control alone is unable to maintain adequate glycemic levels

GDM is a common pregnancy complication associated with increased maternal and fetal morbidity, including pre-eclampsia, preterm birth, cardiovascular disease, and a heightened risk of type 2 diabetes mellitus later in life for the mother, as well as macrosomia, hypoglycemia, and respiratory distress syndrome in the fetus. Initial management typically involves lifestyle and dietary modifications, with insulin therapy serving as the standard of care when these measures fail to achieve glycemic control. While it has been shown that gestational diabetes has an association with pre-eclampsia, the goal of our study is to determine if medical management, such as insulin, contributes to this risk. We created a retrospective cohort study using the NIH-funded All of Us Research Database to compare the incidence of pre-eclampsia between individuals with pre-gestational diabetes and those with gestational diabetes by assessing insulin vs diet controlled treatments in both groups. Our study includes two cohort groups: pre-gestational diabetes

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190 Edward Via College of Osteopathic Medicine (VCOM)