Gestational diabetes mellitus and impaired glucose tolerance in pregnant women

Objective: To evaluate correlations between insulin secretion and resistance in patients with gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT).

Methods: 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.

Results: 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).

Conclusions: 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.