Risk factors for the development of various subtypes of gestational diabetes mellitus

According to modern concepts, the processes of gestational diabetes mellitus (GDM) associated with pancreatic β-cell dysfunction, insulin resistance (IR) or a combination of these factors may prevail in the basis of the formation of GSD, 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. Objective: to establish risk factors for the development of various subtypes of GDM. Materials and methods. 130 pregnant women were examined without a history of carbohydrate metabolism disorders. According to the Matsuda index, the subjects were divided into: group I 45 pregnant women with GSD and β-cell dysfunction, group II 43 pregnant women with GSD and IR, group III 42 pregnant women without GSD (control). The study examined risk factors whose contribution to the development of GSD is already well known, as well as factors that, in our opinion, can influence the development of GSD. Carbohydrate metabolism was evaluated. The data were considered statistically significant at p <0,05. Results. Pregnant women with GDM and IR are characterized by an older age at the onset of pregnancy (p=0,009), signs of acanthosis nigricans (p=0,03), the weight of the first child at birth (p=0,047), a large body weight, rarer intake of folic acid and low physical activity before pregnancy (p <0,001). Patients with GDM and β-cell dysfunction are characterized by a younger age, lack of regular MC before pregnancy (p=0,02), lower body weight and BMI (p <0,001) 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). Conclusion. We have found that in addition to the influence of the patient's age and body weight before pregnancy, low physical activity and lack of pregravidar preparation have an important contribution to the development of various subtypes of GDM.

gestational diabetes mellitus, subtypes of gestational diabetes mellitus, insulin resistance, β-cell dysfunction, risk factors of different subtypes of gestational diabetes mellitus