Intrauterine exposure to hyperglycemia followed by insulin therapy for gestational diabetes (GD) diagnosed according by the HAPO Study new criteria, might lead to pregnancy outcomes which need further studying.The aim
To compare the impact of various kind of therapy on BMI-SDS, height-SDS (H-SDS), adipokines and insulin resistance measured by HOMA in children affected by diabetes during pregnancy.Methods
29 infants born to mothers with gestational diabetes were involved in clinical assessment comprising antropometrics and metabolic characterisation (measurement of growth, BMI-SDS, leptin, adiponectin, HOMA). They were examined twice (just after birth and at 6 months old) and divided into two groups. Group 1 (children whose mothers were administered with insulin, n=16). Group 2 (children whose mothers were administered with diet, n=13). We used c2 and Student criteria for mathematical analysis.Results
At birth BMI-SDS>1 SD was observed in 14%, BMI-SDS<1 SD – in 31% and normal BMI-SDS – in 55% of newborns; H-SDS>1 SD – in 65%, normal H-SDS – in 35% and H-SDS<1 SD was absent in newborns. At the 6 months old these parameters were as follows: BMI-SDS>1 SD – in 17%, BMI-SDS<1 SD – in 20%, normal BMI-SDS – in 63% of children; H-SDS>1 SD – in 35%, H-SDS<1 in 10% and normal H-SDS – in 55% of children. There were not any differences in acceleration or retardation of physical development between 1th and 2nd groups (p<0,05). We found out an increase in insulin resistance in 2nd group (HOMA 5,2±1,04 in 2nd group compared to 2,76±0,45 in 1th group, p<0,05). The level of leptin and adiponectin was not any differences in both groups (leptin 1,34±0,43 in 1th group, 1,03±0,33 in 2nd group, p>0,05; adiponectin 18,56±2,25 in 2nd gr, 21,86±3,33 in 2nd gr, p>0,05.Conclusions
Treatment with insulin of pregnant women affected by GD leads to a decrease in insulin resistance in their children and does not influence a child`s individual physical development during the first 6 months of life.