title: Need for insulin to control gestational diabetes is reflected in the ambulatory arterial stiffness index.
abstract: BACKGROUND
  The aim was to evaluate the metabolic profile in conjunction with vascular function using the ambulatory arterial stiffness index (AASI) in women with uncomplicated pregnancies and in women with gestational diabetes mellitus (GDM).
  
  
  METHODS
  Plasma glucose, lipids, HOMA -IR (homeostasis model assessment of insulin resistance) and AASI, as obtained from 24-hour ambulatory blood pressure monitoring in third trimester pregnancy and at three months postpartum, were measured in three groups of women: controls (N=32), women with GDM on diet (N=42) and women with GDM requiring insulin treatment (N=10).
  
  
  RESULTS
  Women with GDM had poorer glycemic control and higher HOMA-IR during and after pregnancy and their total and LDL (low density lipoprotein) cholesterol levels were significantly higher after pregnancy than in the controls. After delivery, there was an improvement in AASI from 0.26±0.10 to 0.17±0.09 (P=0.002) in women with GDM on diet, but not in women with GDM receiving insulin whose AASI tended to worsen after delivery from 0.30±0.23 to 0.33±0.09 (NS), then being significantly higher than in the other groups (P=0.001-0.047).
  
  
  CONCLUSIONS
  Women with GDM had more unfavorable lipid profile and higher blood glucose values at three months after delivery, the metabolic profile being worst in women requiring insulin. Interestingly, the metabolic disturbances at three months postpartum were accompanied by a tendency towards arterial stiffness to increase in women requiring insulin.
authors: Department of Obst/Gyn, Kuopio University Hospital, University of Eastern Finland, POB 1777, Kuopio FIN-70211, Finland. henna.karkkainen@kuh.fi
authors: Henna
authors: H
authors: Kärkkäinen
authors: Tomi
authors: T
authors: Laitinen
authors: Nonna
authors: N
authors: Heiskanen
authors: Heli
authors: H
authors: Saarelainen
authors: Pirjo
authors: P
authors: Valtonen
authors: Tiina
authors: T
authors: Lyyra-Laitinen
authors: Esko
authors: E
authors: Vanninen
authors: Seppo
authors: S
authors: Heinonen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood*; D016640:Diabetes, Gestational / Q000178:diet therapy / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005387:Finland; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism / Q000627:therapeutic use*; D007333:Insulin Resistance / Q000502:physiology; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000378:metabolism; D011263:Pregnancy Trimester, Third; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D008078:Cholesterol, LDL; D007328:Insulin