Abstract

Hashim Fadhil Al-Tu'ma*, Sura Mohammed Ridha Al-Fakhry, Taha Emad Fadhil Al-Saidey, Zahraa Abdul Kareem Mohammed and Eman Hussein Nasir

ABSTRACT

Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variable severity that occurs during pregnancy. Women with GDM represent a heterogeneous group and are characterized by pancreatic ? cell function that is insufficient to meet body insulin needs, probably due to autoimmune diseases, insulin resistance or genetic abnormalities. Objectives: This study aims to examine the levels of 25(OH)D3 in Iraqi women with normal pregnancies and pregnancies complicated with GDM and then to see its association with insulin, insulin resistance and HbA1c levels. Materials and Methods: This cross-sectional study includes three groups: Group I include 25 pregnant gestational diabetes mellitus (GDM) with age range between 24-43 years. Group II include 23 non-pregnant with type II diabetes mellitus (T2DM) with age ranged between 30 – 39 years. Group III include 29 normal pregnant without GDM and T2DM as control group whose age ranged between 20 – 37 years. All these samples were obtained from gynecology and obstetrics teaching hospital / Kerbala health directorates between Sep., 2019 and June, 2020. The body mass index (BMI), fasting blood glucose, insulin, HbA1c% and 25(OH)D3 were measured immediately, while HOMA-IR was calculated from the resultant data. Results: The mean ± SD value of age of GDM group (34.28 ± 6.44) years was significantly higher than that found in group III and less than that found in group II which contain only T2DM (41.65 ± 6.73) years and for BMI group I was non-significantly higher than that found in group II and significantly higher than that found in group III. Fasting blood glucose, glycated hemoglobin, insulin hormone and insulin resistance was obviously higher in GDM group as compared with normal pregnancy group. Serum insulin levels was higher in GDM group (16.78 ± 7.23) ?IU/mL as compared with both normal pregnant group III (13.05 ± 4.1) ?IU/mL and T2DM group II (14.29 ± 7.68) ?IU/mL. Homeostatic model assessment insulin resistance (HOMA- IR) was found of significantly higher in gestational diabetes mellitus (6.06 ± 2.98) as compared with normal pregnancy group (3.11 ± 0.99) and lower that found in T2DM group (6.97 ± 4.55). In our study we have found a high prevalence of deficiency of 25(OH)D3 in overall study sample. The higher deficiency was found in 56% group I followed by T2DM group II which was present in 65% as compared with normal pregnant group III. The serum 25-(OH)D3 levels obtained were lower in patients who were overweight as compared with other individuals of normal pregnancy group. Conclusion: The diagnosis of GDM usually may occurs after the age of 30 years. The observed data indicated that 25(OH)D3 deficiency or insufficiency status was associated with an increased risk of diabetes mellitus and gestational diabetes and higher insulin and insulin resistance as compared with normal pregnancy.