TO EVALUATE THE IMPACT OF MATERNAL GLYCEMIA ON ANTHROPOMETRY, INSULIN SENSITIVITY, BETA-CELL FUNCTION AND OCCURRENCE OF CONGENITAL MALFORMATIONS IN INFANTS BORN TO GESTATIONAL DIABETIC MOTHERS

Abstract

Background: Studies have shown that children born to diabetic mothers have increased risk for type 2 diabetes in later childhood and adulthood, beta-cell dysfunction and chronic insulin resistance. We undertook the study to evaluate the changes in adiposity, insulin resistance and beta-cell functioning in the infants born to mothers with gestational diabetes.

Objectives: To study the effect of maternal hyperglycemia on anthropometry, adiposity, weight gain, insulin resistance and beta-cell response in infants born to mothers with Gestational Diabetes Mellitus.

Study design: A hospital-based longitudinal study.

Participants: Neonates born to mothers with gestational diabetes were enrolled as cases for the study who were compared to controls, the neonates born to euglycemic mothers.

Methods: All the study subjects underwent assessment anthropometric studies like; body weight, body length, BMI, skinfold thickness and biochemistry studies – serum glucose, insulin, C-peptide levels. Insulin resistance was assessed by the Homeostasis Model Assessment for Insulin resistance (HOMA-IR) and beta-cell functioning was assessed using C-peptide immunoreactivity index (CPRI).

Results: A total of 45 full-term neonates born to singleton pregnancies to mothers with (n=29) and without (n=31) GDM were evaluated at within 24 hours of birth, 6 months and 1 year of age. In general, the IGDM weighed 680g more than NIDM at birth (p <0.001), 250 g more at 6 months of age (p <0.001) and 100 g more at 1 year of age (p= 0.230). Skinfold thickness (SFT) was significantly more in Infants to diabetic Mothers at birth (p <0.001) and 6 months (p <0.001) while 1 year of age the difference was insignificant (p =0.168). The HOMA-IR in IGDMs was significantly higher (p <0.001) at birth but comparable at 6 months (p= 0.613) and 1 year (p= 0.535) . CPRI at birth was higher (p <0.001) at birth, higher but statistically insignificant at 6 months (p= 0.552) and 1 year (p= 0.965) .2 out of 29 IGDM (6.9%) and 2 out of 31 INDM (6.5%) had congenital anomaly present (p= 0.98) .

Conclusion: Infants born to gestational diabetic mothers had higher anthropometry, adiposity, insulin resistance and exaggerated beta-cell response at birth but exhibit a catch-down growth during infancy to ultimately reach their INDM peers at the end of 1st year.