<strong>Background: </strong>Progressive insulin resistance (IR) is an important pathophysiologic mechanism of gestational diabetes mellitus (GDM). Homeostatic model assessment (HOMA) is commonly used as a...<strong>Background: </strong>Progressive insulin resistance (IR) is an important pathophysiologic mechanism of gestational diabetes mellitus (GDM). Homeostatic model assessment (HOMA) is commonly used as a parameter of the severity of insulin resistance. <strong>Aims:</strong> To determine indices of insulin resistance (IR) and <em>β</em>-cell function in gestational diabetes mellitus (GDM). <strong>Methods:</strong> This cross sectional study was conducted from March 2017 to September 2018 at Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. The study was performed with 41 GDM and equal number of pregnant women with normal glucose tolerance (NGT) diagnosed on basis of WHO criterion-2013 during 24 - 40 weeks of gestation. Serum glucose was measured by glucose oxidase method and fasting serum insulin was measured by chemiluminescent immunoassay. Equations of homeostatic model assessment (HOMA) were used to calculate insulin indices like-insulin resistance (HOMA-IR), <em>β</em>-cell function (HOMA-B) and insulin sensitivity (HOMA-%S). Data were analyzed and compared by statistical tests. <strong>Results: </strong>A total of eighty-two (82) subjects [41 women with GDM (age: 28.29 ± 3.79 years, BMI: 27.16 ± 4.13 kg/m2) and 41 women with NGT (age: 26.22 ± 5.13 years, BMI: 25.27 ± 3.01 kg/m2)] were included in this study. It was observed that GDM women were significantly older (p = 0.041) and had significantly higher BMI (p = 0.020) than pregnant women with NGT. The GDM group had significantly higher IR as indicated by higher fasting insulin value [GDM vs. NGT;10.19 (7.71 - 13.34) vs. 6.88 (5.88 - 8.47) μIU/ml, median (IQR);p = 0.001] and HOMA-IR [GDM vs. NGT;2.31 (1.73 - 3.15) vs. 1.42 (1.15 - 1.76), median (IQR);p < 0.001], poor <em>β</em>-cell secretory capacity [GDM vs. NGT;HOMA-B: 112.63 (83.52 - 143.93) vs. 128.60 (108.77 - 157.58), median (IQR);p = 0.04] and low insulin sensitivity [GDM vs. NGT;HOMA-%S: 43.29 (31.77 - 57.98) vs. 70.42 (56.86 - 86.59), me展开更多
Objective: To compare GA with A1Cin monitoring glycemic excursions during pregnancy. Research Design and Methods: This study included 30 women with Gestational Diabetes Mellitus (GDM) and an equal number with Normal G...Objective: To compare GA with A1Cin monitoring glycemic excursions during pregnancy. Research Design and Methods: This study included 30 women with Gestational Diabetes Mellitus (GDM) and an equal number with Normal Glucose Tolerance (NGT). GDM were followed up every 2 weeks till 36 - 37 weeks and NGT were reviewed monthly once. Fasting Plasma Glucose (FPG), Postprandial Plasma Glucose (PPG), Ferritin, GA and A1Cwere estimated. GDM were advised Medical Nutritional Therapy (MNT). Target glycemic control was FPG ~ 5 mmol/L and 2 hr PPG ~ 6.6 mmol/L. Non-responders to MNT were administered insulin. Results: In GDM, mean FPG was 5.16 ± 0.55 mmol/L in the first visit and 4.73 ± 0.52 mmol/L in the last visit. The PPG at first visit was 7.07 ± 1.51 mmol/L and 6.16 ± 0.70 mmol/L in the last visit. The mean GA was 12.48% ± 0.8%, 12.51% ± 0.9%, 12.40% ± 1.0%, 12.30% ± 0.86% and 12.38% ± 0.87% at the first, second, third, fourth and fifth visit respectively. The mean A1Cat first, third and fifth visits was 5.16% ± 0.35%, 5.24% ± 0.29% and 5.21% ± 0.28% respectively. In NGT women, mean FPG at first visit was 4.37 ± 0.37 mmol/L and 4.39 ± 0.43 mmol/L in the last visit. The mean PPG was 5.95 ± 1.01 mmol/L in the first visit and 5.75 ± 1.61 mmol/L in the last visit. The mean GA was 12.17% ± 0.85% in first visit and 12.10% ± 0.77% in the last visit. A1Cwas 4.84% ± 0.31% and 4.91% ± 0.33% in the first and last visit respectively. Conclusions: Glycemic control was observed earlier with GA than A1C. GA is a better indicator of recent past short-term glycemic control in GDM.展开更多
<strong>Background:</strong> Aberrant lipid metabolism presumed to have important relationship with gestational diabetes mellitus (GDM), though previous studies revealed inconsistent results on this area.&...<strong>Background:</strong> Aberrant lipid metabolism presumed to have important relationship with gestational diabetes mellitus (GDM), though previous studies revealed inconsistent results on this area.<strong> Objectives:</strong> To identify the difference of serum lipid profile between gestational diabetes mellitus (GDM) and pregnant woman with normal glucose tolerance (NGT). <strong>Methods:</strong> This cross sectional study was conducted from January 2017 to December 2017 at Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with 31 GDM and equal number of NGT pregnant women diagnosed on the basis of WHO criteria-2013, during 24 - 40 weeks of gestation. Glucose was measured by glucose oxidase method and fasting serum lipid profile [Total cholesterol (TC), High Density Lipoprotein-cholesterol (HDL-C) and Triglyceride (TG)] was measured by enzymatic-colorimetric method. Data were analyzed and compared by statistical tests. <strong>Results: </strong>Among total sixty-two (62) study subjects, 31 were GDM (age: 27.52 ± 4.8 years, body mass index (BMI): 27.17 ± 3.3 kg/m<sup>2</sup>) and 31 were pregnant women with NGT (age: 24.94 ± 4.2 years, BMI: 25.43 ± 6.5 kg/m<sup>2</sup>). Mean age of GDM group was significantly higher than that of NGT group (p = 0.028). Women with GDM showed relatively higher BMI than NGT women but that was not statistically significant (p = 0.194). Fasting lipid profiles between GDM and NGT (GDM vs. NGT;total cholesterol: 194.21 ± 42.18 vs. 208.52 ± 42.18 mg/dl, p = 0.187;HDL-C: 47.50 ± 16.17 vs. 47.18 ± 11.71 mg/dl, p = 0.928;LDL-C: 109.25 ± 28.80 vs. 119.30 ± 34.76 mg/dl, p = 0.220 and triglyceride 204.78 ± 58.50 vs. 202.34 ± 79.18 mg/dl, p = 0.891) were not significantly different. The variations in all lipid fraction values were not statistically significant among GDM women when analyzed between BMI groups holding BMI cut-off at 23 kg/m<sup>2</sup>. No significant differences of any values of lipid profile were found in GD展开更多
文摘<strong>Background: </strong>Progressive insulin resistance (IR) is an important pathophysiologic mechanism of gestational diabetes mellitus (GDM). Homeostatic model assessment (HOMA) is commonly used as a parameter of the severity of insulin resistance. <strong>Aims:</strong> To determine indices of insulin resistance (IR) and <em>β</em>-cell function in gestational diabetes mellitus (GDM). <strong>Methods:</strong> This cross sectional study was conducted from March 2017 to September 2018 at Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. The study was performed with 41 GDM and equal number of pregnant women with normal glucose tolerance (NGT) diagnosed on basis of WHO criterion-2013 during 24 - 40 weeks of gestation. Serum glucose was measured by glucose oxidase method and fasting serum insulin was measured by chemiluminescent immunoassay. Equations of homeostatic model assessment (HOMA) were used to calculate insulin indices like-insulin resistance (HOMA-IR), <em>β</em>-cell function (HOMA-B) and insulin sensitivity (HOMA-%S). Data were analyzed and compared by statistical tests. <strong>Results: </strong>A total of eighty-two (82) subjects [41 women with GDM (age: 28.29 ± 3.79 years, BMI: 27.16 ± 4.13 kg/m2) and 41 women with NGT (age: 26.22 ± 5.13 years, BMI: 25.27 ± 3.01 kg/m2)] were included in this study. It was observed that GDM women were significantly older (p = 0.041) and had significantly higher BMI (p = 0.020) than pregnant women with NGT. The GDM group had significantly higher IR as indicated by higher fasting insulin value [GDM vs. NGT;10.19 (7.71 - 13.34) vs. 6.88 (5.88 - 8.47) μIU/ml, median (IQR);p = 0.001] and HOMA-IR [GDM vs. NGT;2.31 (1.73 - 3.15) vs. 1.42 (1.15 - 1.76), median (IQR);p < 0.001], poor <em>β</em>-cell secretory capacity [GDM vs. NGT;HOMA-B: 112.63 (83.52 - 143.93) vs. 128.60 (108.77 - 157.58), median (IQR);p = 0.04] and low insulin sensitivity [GDM vs. NGT;HOMA-%S: 43.29 (31.77 - 57.98) vs. 70.42 (56.86 - 86.59), me
文摘Objective: To compare GA with A1Cin monitoring glycemic excursions during pregnancy. Research Design and Methods: This study included 30 women with Gestational Diabetes Mellitus (GDM) and an equal number with Normal Glucose Tolerance (NGT). GDM were followed up every 2 weeks till 36 - 37 weeks and NGT were reviewed monthly once. Fasting Plasma Glucose (FPG), Postprandial Plasma Glucose (PPG), Ferritin, GA and A1Cwere estimated. GDM were advised Medical Nutritional Therapy (MNT). Target glycemic control was FPG ~ 5 mmol/L and 2 hr PPG ~ 6.6 mmol/L. Non-responders to MNT were administered insulin. Results: In GDM, mean FPG was 5.16 ± 0.55 mmol/L in the first visit and 4.73 ± 0.52 mmol/L in the last visit. The PPG at first visit was 7.07 ± 1.51 mmol/L and 6.16 ± 0.70 mmol/L in the last visit. The mean GA was 12.48% ± 0.8%, 12.51% ± 0.9%, 12.40% ± 1.0%, 12.30% ± 0.86% and 12.38% ± 0.87% at the first, second, third, fourth and fifth visit respectively. The mean A1Cat first, third and fifth visits was 5.16% ± 0.35%, 5.24% ± 0.29% and 5.21% ± 0.28% respectively. In NGT women, mean FPG at first visit was 4.37 ± 0.37 mmol/L and 4.39 ± 0.43 mmol/L in the last visit. The mean PPG was 5.95 ± 1.01 mmol/L in the first visit and 5.75 ± 1.61 mmol/L in the last visit. The mean GA was 12.17% ± 0.85% in first visit and 12.10% ± 0.77% in the last visit. A1Cwas 4.84% ± 0.31% and 4.91% ± 0.33% in the first and last visit respectively. Conclusions: Glycemic control was observed earlier with GA than A1C. GA is a better indicator of recent past short-term glycemic control in GDM.
文摘<strong>Background:</strong> Aberrant lipid metabolism presumed to have important relationship with gestational diabetes mellitus (GDM), though previous studies revealed inconsistent results on this area.<strong> Objectives:</strong> To identify the difference of serum lipid profile between gestational diabetes mellitus (GDM) and pregnant woman with normal glucose tolerance (NGT). <strong>Methods:</strong> This cross sectional study was conducted from January 2017 to December 2017 at Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with 31 GDM and equal number of NGT pregnant women diagnosed on the basis of WHO criteria-2013, during 24 - 40 weeks of gestation. Glucose was measured by glucose oxidase method and fasting serum lipid profile [Total cholesterol (TC), High Density Lipoprotein-cholesterol (HDL-C) and Triglyceride (TG)] was measured by enzymatic-colorimetric method. Data were analyzed and compared by statistical tests. <strong>Results: </strong>Among total sixty-two (62) study subjects, 31 were GDM (age: 27.52 ± 4.8 years, body mass index (BMI): 27.17 ± 3.3 kg/m<sup>2</sup>) and 31 were pregnant women with NGT (age: 24.94 ± 4.2 years, BMI: 25.43 ± 6.5 kg/m<sup>2</sup>). Mean age of GDM group was significantly higher than that of NGT group (p = 0.028). Women with GDM showed relatively higher BMI than NGT women but that was not statistically significant (p = 0.194). Fasting lipid profiles between GDM and NGT (GDM vs. NGT;total cholesterol: 194.21 ± 42.18 vs. 208.52 ± 42.18 mg/dl, p = 0.187;HDL-C: 47.50 ± 16.17 vs. 47.18 ± 11.71 mg/dl, p = 0.928;LDL-C: 109.25 ± 28.80 vs. 119.30 ± 34.76 mg/dl, p = 0.220 and triglyceride 204.78 ± 58.50 vs. 202.34 ± 79.18 mg/dl, p = 0.891) were not significantly different. The variations in all lipid fraction values were not statistically significant among GDM women when analyzed between BMI groups holding BMI cut-off at 23 kg/m<sup>2</sup>. No significant differences of any values of lipid profile were found in GD
