Impaired microvascular reactivity in gestational diabetes is associated with altered glycemic parameters.

OBJECTIVES: To assess microvascular reactivity and glycemic parameters in gestational diabetes mellitus (GDM) compared to age and gestational age (GA) matched controls.

METHODS: This study involved 21 GDM patients and 31 controls. Microvascular reactivity was assessed using laser Doppler fluximetry and post-occlusive skin reactive hyperemia (PORH). Microvascular parameters; PORHmax , PORHpeak , and time to peak perfusion (Tp) were recorded after release of three minutes' upper arm occlusion. Homeostasis model assessment for insulin resistance (HOMA-IR) was performed to evaluate insulin resistance.

RESULTS: Average age and GA for subjects were 32.9 years and 29.2 weeks. Mean fasting blood glucose (FBG) and a two-hour postprandial for GDM and controls were 4.87 ± 0.71 vs 3.99 ± 0.59 mmol/L; p <0.001 and 9.50 ± 1.8 vs 5.67 ± 1.0 mmol/L; p <0.001. Fasting insulin (13.88 ± 18.9 vs 8.37 ± 11.0 μlU/ml; p = 0.031) and HOMA-IR (3.14 ± 4.6 vs 1.52 ± 2.2; p = 0.004) were higher in GDM. Tp was prolonged in GDM (16.27 ± 4.3 vs 13.86 ± 2.1 sec.; p = 0.011). Positive correlations were seen between Tp and FBG and two-hour postprandial levels.

CONCLUSION: Tp was prolonged in GDM compared to age matched controls, indicating impaired microvascular reactivity. This article is protected by copyright. All rights reserved.