Gestational diabetes mellitus and impaired glucose tolerance in pregnant women

ABSTRACT

To evaluate correlations between insulin secretion and resistance in patients with gestational diabetes mellitus [GDM] and gestational impaired glucose tolerance [GIGT]. Three hundred thirty six pregnant women with an oral glucose tolerance test [OGTT] were tested and measured insulin function indices [IFI], insulin resistance indices [HOMA-IR] as well as blood serum triglycerides [TG], total cholesterol [TCH] and low density lipoprotein cholesterol [LDL-C] concentrations. GIGT patients were further divided into subgroups according to hyperglycemia appearance 1, 2 or 3 hours after glucose ingestion. GDM and GIGT correlated with age [p<0.05], family history of diabetes [p<0.05] and pre-pregnancy body mass indices [BMIs] [p<0.05]. Blood pressures were higher in GDM than in GIGT and normal glucose tolerance [NGT] patients [p<0.05]. The IFIs were gradually reduced [p<0.05], whereas HOMA-IR was gradually enhanced [p<0.05] in the GIGT and GDM patients. Blood serum TG, TCH and LDL-C concentrations were higher in the GIGT and GDM groups [p<0.05] and the GIGT 1 hour hyperglycemia subgroup had highest pregnancy weight gain and HOMA-IR values [p<0.05]. Advanced age, family history of diabetes, high BMIs and blood pressure were risk factors for GIGT and GDM, which were both caused by reduced insulin secretion and enhanced insulin resistance