Background: The onset of gestational diabetes (GD) is closely related to hormonal and metabolic parameters and environmental predisposition.
Aims: This first study of screening and diagnosis of GD in the Algerian population compares the changes in metabolic and endocrine parameters in relation to the state of insulin resistance, BMI and age between women diagnosed positive (GD) and negative (control).
Patients and methods: After HbA1c test, OSullivan oral glucose tolerance test (OSullivan OGTT 100 g) was performed on 36 women aged 2045 years, at 2428 weeks amenorrhea admitted in the high-risk pregnancies service. Fasting blood glucose, lipidemia, insulin, estradiol, progesterone, cortisol, human placental lactogen (HPL), leptin, adiponectin, and HOMA-IR were compared in both groups.
Results: In absence of previous type 2 diabetes (HbA1c <6), screening reveals four GD patients with insulin resistance (HOMA-IR: 7.48±2.435 vs 4.44±0.438), a slight rise in lipidemia, an increase of both leptin and adiponectin by 33 and 88% respectively and a higher adiponectin/leptin ratio in GD group (0.67 vs 0.56). Oestradiol, progesterone, HPL, cortisol levels show a slight increase BMI reveals no obese status among GD group (thin and overweight), against 15.6% obese and 34.3% overweight in control group, while GD two were aged under 35 years vs 75%. Diabetic profile disappeared after delivery.
Conclusions: The risk of gestational diabetes depends upon BMI and age. The increased level of adiponectin and adiponectin/leptin rate consequently to the absence of obesity among GD women seems to mitigate the severity of insulin resistance and may play a protective role against the achievement of a postpartum type 2 diabetes.