Peculiar Properties of Metabolism Women with Gestational Diabetes Mellitus
Orazmuradov A.A., Savenkova I.V., Arakelyan G.A., Damirova S.F., Papysheva O.V., Lukanovskaya O.B..
The aimed of the study was to evaluate the peculiar properties of metabolism and the value of markers of insulin resistance women with gestational diabetes mellitus.
Methods: This was a prospective case-control study. The study included 219 pregnant women with GDM and 200 without disorders of carbohydrate metabolism, who gave birth during the period: II quarter of 2017– III quarter of 2018 in the maternity ward of the city clinical hospital â„–29 named after N.E Bauman in Moscow.
Results: The combination of GDM and obesity was observed for 94 (42.9%) patients. For 123 (56.2%) women obesity was family-like, occurring with relatives of the 1st and 2nd lines. In the group on dietary therapy, the proportion of pregnant women with obesity of grade 1–3 was 50%, which is 1.3 times less than among those who received insulin. Indicators of the level of insulin resistance (IR), the lipid spectrum of blood plasma was significantly worse in the group which received diet therapy: cholesterol 6,3 (5,7; 6,9) mmol / L, high density lipoproteins (LHL) 3,2 (2,8; 3,9) mmol / L, C-peptide 2,9 (1,9; 5,2 mmol / L) comparing to the group on insulin therapy: cholesterol 5,9 (5,4; 7,2) mmol / L, LHL 3,2 (2,6; 4,1) mmol / L, C-peptide 22,2 (1,6; 2,8) mmol / L (?œ?µ 25%,75%). The most frequent complication of pregnancy for patients with GDM was moderate pre-eclampsia, occurred with 126 (57.5%) women comparing to the control group - 6 (18.2%). For 77 (35.5%) patients with GDM pregnancy was complicated by the threat of interruption in the 1st trimester and for 53 (24.2%) in the 2nd trimester.
Conclusion: In the conditions of late diagnosis of GDM, late initiation of insulin therapy, indicators of IR level were worse for patients on diet therapy comparing to those who received insulin (C-peptide level, LDL). Information obtained allow us to consider GDM as a special form of metabolic syndrome.