Variants of Oral Glucose Tolerance Test (ogtt) Curve in Gestational Diabetes Mellitus (gdm)

Objective: Gestational diabetes mellitus is defined as “carbohydrate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during pregnancy, whether or not insulin is used and regardless of whether diabetes persists after pregnancy. There is evidence that asymptomatic hyperglycemia during pregnancy leads to important morbidity in the mother and foetus. Hence, early detection and treatment of GDM will definitely reduce the complications and bring down the morbidity. Methods: Test was performed using 100 gm oral glucose. Blood samples were taken at 1hr, 2hr and 3hr as per standard protocol. Blood glucose was measured by glucose oxidase enzymatic method and all the values were tabulated and plotted on a graph. Interpretation was done using Carpenter and Coustan Criteria. Results: Out of the 96 women, 15 women were diagnosed as GDM. 5 out of them showed atypical pattern in OGTT curve. Similar such patterns were also seen in 5 normal subjects. Conclusion: In GDM with mild to moderate elevation in fasting plasma glucose, fasting plasma insulin is elevated in parallel. The presence of IGT in pregnancy is predictive of poor pregnancy outcomes. High 2 hour glucose could be a marker of poor health. INTRODUCTION: Diabetes mellitus is a chronic disorder characterized by raised blood sugar level which is due to impaired insulin secretion or resistance or both. Around 180 million people worldwide have diabetes according to World Health Organization . This number is likely to be more than double by 2030. India has largest number of people with diabetes in the world with an estimate of 31.7 million in 2000. This number is predicted to increase to 79.4 million by 2030. Gestational diabetes mellitus is defined as “carbohydrate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during pregnancy, whether or not insulin is used and regardless of whether diabetes persists after pregnancy” 2, . Normal pregnancy is associated with increased insulin resistance especially in the late second and third trimesters and euglycemia is maintained by increased insulin secretion, while GDM develops in those women who failed to augment insulin sufficiently 4, . There are different studies on GDM occurring in 1-14% of pregnancies depending on population studies and diagnostic tests employed 3, 6, 7, .