Blood pressure and lipid changes in gestational diabetes mellitus.

OBJECTIVE: It is suggested that gestational diabetes mellitus (GDM) is the earliest phase of DM. Nowadays DM is treated as a part of insulin resistance syndrome--patients with DM tend to be obese, dyslipidemic and hypertensive. It is postulated that similar abnormalities are found in GDM patients.

METHODS: The study was conducted among 81 women with GDM and 41 healthy controls. After diagnosis or negative screening for GDM the women underwent 24-hour blood pressure monitoring and measurements of plasma lipids, insulin concentrations and insulin resistance (expressed by HOMA score). The incidence of gestational hypertension and blood pressure until delivery was also analyzed.

RESULTS: 17 (21%) of GDM women and only 1 glucose tolerant control developed pregnancy induced hypertension. GDM women had significantly higher arterial pressure during the daytime and nighttime (accordingly 112.1/69.4 mmHg vs. 105.4/64.8 mmHg and 101.5/62.4 mmHg vs. 93.0/58.8 mmHg), although the average BP was within normal range. Heart rate was also faster in GDM group. Compared with healthy pregnant women, GDM patients had higher serum TG concentrations (247,9 vs 205 mg%; p<0,01), fasting insulin (66 vs 42,5 pmol/l; p<0,001) and insulin resistance (HOMA 2,15 vs 1,13; p<0,001). No correlation was found between blood pressure and insulin concentrations and insulin resistance among healthy and GDM women.

CONCLUSIONS: The results suggest that symptoms of insulin resistance are present in GDM women. They are characterized by higher arterial blood pressure, heart rate, serum triglycerides, insulin and increased insulin resistance.