Insulin Resistance and Gestational Diabetes Mellitus in Pregnancy – a Tertiary Care Hospital Based Study
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Background - Pregnancy triggers numerous changes in metabolism, biochemistry, physiology, hematology, and immunity. Healthy pregnant women may develop resistance to insulin's effects on glucose absorption and utilization. The TG/HDL has been advocated as a simple clinical indicator of insulin resistance. The relationship between lipid profiles, insulin resistance and gestational diabetes mellitus (GDM) remains controversial. Aim - This research seeks to investigate the relationship between the ratio of Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) as a marker for Insulin resistance and the association of IR and GDM in pregnancy. Materials and methods - The study included 1040 pregnant mothers selected randomly attending for routine antenatal checkup. The study participants were in the age group of 18-40 years. OGTT is performed in pregnant women by measuring the plasma glucose after 2 hours of fasting or non-fasting after ingesting 75 grams of glucose. A single value of ≥140 mg/dl is diagnostic for Gestational Diabetes Mellitus according to Technical and operational guidelines of diagnosis and management of GDM by MOHFW, Govt of India. Lipid parameters and IR was also looked for. Results - OGTT, IR, TC, TG, VLDL was found to be significantly elevated among GDM mothers. GDM and IR was found to increase as maternal age increases. OGTT has been found to be significantly positively correlated to IR. Also TC was found to be significantly correlated to LDL. Conclusion - A positive correlation between total cholesterol, and insulin resistance shows that as cholesterol levels rise, insulin resistance also increases, elevating the risk of GDM. These correlations are crucial for understanding the metabolic health implications in pregnant women. It is concluded that due to alterations in lipid parameters, insulin resistance in pregnant women increases which causes a significant impact on Gestational Diabetes Mellitus.
