RESUMO
Background: Gestational Diabetes Mellitus (GDM) is usually diagnosed between 24th and 28th gestational week using the 75-g Oral Glucose Tolerance Test (OGTT). It is controversial that if FPG ?92 mg/dL before 24th gestational week should be intervened or not. The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy Body Mass Index (BMI).Methods: This was a hospital based retrospective cohort study done at CHC Balipatna, Khurdha, Odisha. Women who had a singleton live birth between June 20, 2016 and June 30, 2019, resided in Balipatna block area and received prenatal care in the Community Health Centre, were included in this study. Pre-pregnancy BMI, FPG before the 24th gestational week, and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical records and analyzed. The pregnant women were classified into four groups based on pre-pregnancy BMI: Group A (underweight), Group B (normal), Group C (overweight) and Group D (obesity). Statistical analysis using independent sample t-test, Analysis of Variance (ANOVA) and Pearson Chi-square test was done.Results: The prevalence of GDM was 20.0% (68/341) in the study population. FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. The incidence of GDM in women with FPG ?92 mg/dL in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG ?92 mg/dL and pre-pregnancy BMI <24.0 kg/m2.Conclusions: FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week. FPG ?92 mg/dL between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.
RESUMO
Background: Wide variation in the lipid profile in pregnancy is quite common. Exaggerated changes in insulin and lipid levels in women with GDM during pregnancy, lead to significant alterations in lipid levels in comparison to normal pregnancy. Lipid metabolism during pregnancy has a significant role to play in the aetiology and pathogenesis of GDM as is indicated by various studies previously.Methods: A hospital-based case control study was conducted at Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha in the Department of Endocrinology. The sample size was 100 pregnant women. Study period was of one year from June 2018 to June 2019. In women of both the groups, i.e., with GDM and without GDM the mean age of presentation were 20-25 yrs. Out of the 100 cases, we took 50 patients of GDM in the cases group and 50 patients of non GDM pregnant women as control group. Fasting lipid profile was sent to the hospital laboratory analyzed by Tinder’s methods. The results thus obtained were analyzed using student ‘t’ test for statistical significance using SPSS version 20.Results: There was no statistical difference in age and parity between control and case group. Triglyceride (cases- 286.4±77.60 mg/dl) (controls-166±26mg/dl), total cholesterol (cases-256.5±41.7 mg/dl) (controls - 202.5±20.18mg/dl), VLDL (cases-53.4±13.2 mg/dl) (controls-46.6±13.1mg/dl) showed statistically significant values (p value<0.001). HDL and LDL values did not show any statistical significance (p value >0.5) among GDM and non GDM group. Lipid profile was performed predominately in women in II trimester.Conclusions: In comparison to non GDM women, it was observed that serum triglyceride, total cholesterol and VLDL level are significantly higher in woman with GDM. Whether lipid profile can be used as a predictor for gestational diabetes mellitus in future needs further research.