THU317 Study Of Risk Factors For The Development Of Various Subtypes Of Gestational Diabetes Mellitus

Abstract

Abstract Disclosure: N.I. Volkova: None. I. Davidenko: None. J. Sorokina: None. J. Degtyareva: None. V. Kovalenko: None. Abstract: Gestational diabetes mellitus (GDM) poses a threat to the health of the mother and a high risk of perinatal complications, however, achieving normoglycemia will significantly improve the prognosis in such pregnant women. One of the factors determining the most optimal management tactics is based on the pathophysiological mechanism of GDM formation. According to modern concepts, the processes associated with pancreatic β-cell dysfunction, insulin resistance (IR) or a combination of these factors may prevail in the basis of the formation of GDM, forming various subtypes of GDM. Identification of risk factors for the development of various subtypes of GDM in pregnant women may be important for timely verification and selection of therapy. In order to study risk factors for the development of various subtypes of GDM 130 pregnant women were examined without a history of carbohydrate metabolism disorders. The subjects were divided into: group I - 45 pregnant women with GDM and β-cell dysfunction, group II - 43 pregnant women with GDM and IR, group III - 42 pregnant women without GDM (control). The risk factors, whose contribution to the development of GDM is already well known, and the factors that, in our opinion, can influence the development of GDM, were studied. We conducted a full clinical examination. Carbohydrate metabolism was assessed according to fasting venous plasma glucose, oral glucose tolerance test with 75 g of glucose. The function of β-cells was evaluated and IR was detected. According to the Matsuda index, subtypes of GDM were identified. Statistical processing was carried out using comparative analysis. The data are presented in the form of medians and interquartile intervals of quantitative indicators in the groups, the data were considered reliable at p<0.05. Pregnant women with GDM and IR are characterized by an older age at the onset of pregnancy [32 (29; 35) y.o, p = 0.009], a large body weight [84 (76; 91) kg, p <0.001], signs of acanthosis nigricans (14%, p=0.03), weight of 1 child at birth (p= 0.047), rarer intake of folic acid (p< 0.001), low physical activity before pregnancy (p<0.001). Patients with GDM and β-cell dysfunction are characterized by a younger age [29 (27; 31) y.o.; p= 0.02], lower body weight [59.8 (55.9; 76.4) kg, p <0.001] and BMI [21.9 (20.7; 26.6) kg/m2, p <0.001], absence of regular MC before pregnancy (93%, p=0.02) and more frequent use of folic acid (p=0.048). Both groups of patients were characterized by the absence of pre-gravidar preparation (p=0.03).Thus, we have studied known risk factors for GDM, as well as factors that could potentially cause the development of hyperglycemia during pregnancy. And it turned out that in addition to the influence of the patient's age and body weight before pregnancy, an important contribution to the development of various subtypes of GDM is provided by low physical activity and lack of pregravidar preparation. Presentation: Thursday, June 15, 2023