|
|
|
| Relationship between the velocity of blood glucose level increase after oral glucose tolerance test and the insulin secretion situation of pregnant women with gestational diabetes mellitus and their adverse pregnancy outcomes |
| The First People's Hospital of Suzhou, Anhui Province,234000 |
|
|
|
|
Abstract To analyze the relationship between the velocity of blood glucose level increase after oral glucose tolerance test (OGTT) and the insulin secretion situation of pregnant women with gestational diabetes mellitus (GDM) and their adverse pregnancy outcomes. Methods: 258 pregnant women with GDM were selected in this study from January 2017 to December 2019. According to trigrams of the velocity mean (Vmean) of blood glucose level increase after OGTT, these women were divided into group A (women with low Vmean), group B (women with medium Vmean), and group C (women with high Vmean). The insulin secretion patterns at I0, I30, I60, I120, and I180, the insulin resistance indicators values, and the adverse pregnancy outcomes were compared among the three groups. And the correlation between the Vmean of the women and their insulin resistance indicators values and adverse pregnancy outcomes was analyzed. Results: The peak of insulin secretion of the women in group C was delayed. The peak of insulin secretion of the women in group A, group B, and group C at I0 and I120 had increased gradually (P＜0.05). The peak of insulin secretion of the women in group C at I30, I60, or I180 was significantly higher than that of the women in group A and group B (P＜0.05). There was no significant difference in the peak of insulin secretion of the women at I30, I60, and I180 between group A and group B (P＞0.05). The homeostasis model assessment of insulin resistance (HOMA-IR) of the women in group A, group B, and group C had increased gradually (P＜0.05). The values of homeostasis model assessment of insulin islet β cell (HOMA-β) and early phase insulin secretion index (δ I30/ δ G30) of the women in group C were significantly higher than those of the women in group A and group B (P＜0.05), and which of the women in group A had no significant different from those of the women in group B (P＞0.05). The value of HOMA-IR of the women was positively correlated with their Vmean value (P＜0.001). The incidence of poor blood glucose control and the total incidence of adverse pregnancy outcomes of the women in group C were significantly higher than those of the women in group A and group B (P＜0.05), and which of the women had no significant difference between group A and group B (P＞0.05). The incidences of polyhydramnios and fetal distress of the women in group C were significantly higher than those of the women in group A and group B (P＜0.05), and which of the women had no significant difference between group A and group B (P＞0.05). Age ≥35 years, poor blood glucose control, gestational weight gain ≥15kg, Vmean≥0.119mmol/L/min were the independent risk factors of adverse pregnancy outcomes (P＜0.05). Conclusion: The higher velocity of blood glucose level increase of the pregnant women with GDM can aggravate their insulin resistance and can increase their risk of adverse pregnancy outcomes.
|
|
|
|
|
|
|
|
|
