Vol 8, No 11 (2007): Practical Diabetology
Research paper
Published online: 2008-02-04
The assessment of thyroid status during pregnancy complicated by pregestational or gestational diabetes mellitus and pregnant women without diabetes
Diabetologia Praktyczna 2007;8(11):414-418.
Abstract
INTRODUCTION. The aim of the study was to assess
hormonal changes and thyroid function in pregnant
women with pregestational and gestational diabetes
and compare to healthy women.
MATERIAL AND METHODS. We analysed data of 448 women treated in Department of Metabolic Disease in Krakow between 2002-2006 years. We analysed data: 320 women with gestational diabetes - 200 treated by diet (G/A) and 120 by intensive insulin therapy (G/B), 53 with diabetes mellitus types 1 (PGDM) and 75 pregnant women without diabetes as a control group (CG). The diagnosis of gestational diabetes was assess using an oral glucose tolerance test with 75 g of glucose performed 27,5 (± 5,0) weeks of pregnancy. We measured TSH, free T3 and T4, HbA1c level.
RESULTS. Those groups did not differ between age. Mean body weight was statistically higher in group with gestational diabetes treated by diet as compared to the pregestational diabetes group 75.1 kg (± 103.1) vs. 69.1 kg (± 14.8); p = 0.004. The serum level of TSH and fT3 did not differ in the all groups. The statistically higher serum fT4 level was in the PGDM than the others, respectively PGDM 13.0 (± 2.6) vs. G/A 11.3 (± 2.2) pmol/l; p < 0.001, vs. G/B 11.8 (± 2.5) pmol/l; p < 0.003 and vs. CG 11.1 (± 2.0) pmol/l; p < 0.0001. In the PGDM and G/B group we found statistically higher level of HbA1c than G/A and control group, respectively 6.1 (± 1.1) vs. 5.1 (± 0.6) vs. 4.9 (± 0.4) and 4.8% (± 0.3); p = 0.0003.
CONCLUSIONS. We observed the decreased serum thyroid level in the whole group of pregnant women, but there was the highest fT4 level in the pregestational group. During pregnancy complicated by pregentational or gestational diabetes we observed poorly control of glycaemia and highest daily glycaemia which could potentially affect a pregnancy.
MATERIAL AND METHODS. We analysed data of 448 women treated in Department of Metabolic Disease in Krakow between 2002-2006 years. We analysed data: 320 women with gestational diabetes - 200 treated by diet (G/A) and 120 by intensive insulin therapy (G/B), 53 with diabetes mellitus types 1 (PGDM) and 75 pregnant women without diabetes as a control group (CG). The diagnosis of gestational diabetes was assess using an oral glucose tolerance test with 75 g of glucose performed 27,5 (± 5,0) weeks of pregnancy. We measured TSH, free T3 and T4, HbA1c level.
RESULTS. Those groups did not differ between age. Mean body weight was statistically higher in group with gestational diabetes treated by diet as compared to the pregestational diabetes group 75.1 kg (± 103.1) vs. 69.1 kg (± 14.8); p = 0.004. The serum level of TSH and fT3 did not differ in the all groups. The statistically higher serum fT4 level was in the PGDM than the others, respectively PGDM 13.0 (± 2.6) vs. G/A 11.3 (± 2.2) pmol/l; p < 0.001, vs. G/B 11.8 (± 2.5) pmol/l; p < 0.003 and vs. CG 11.1 (± 2.0) pmol/l; p < 0.0001. In the PGDM and G/B group we found statistically higher level of HbA1c than G/A and control group, respectively 6.1 (± 1.1) vs. 5.1 (± 0.6) vs. 4.9 (± 0.4) and 4.8% (± 0.3); p = 0.0003.
CONCLUSIONS. We observed the decreased serum thyroid level in the whole group of pregnant women, but there was the highest fT4 level in the pregestational group. During pregnancy complicated by pregentational or gestational diabetes we observed poorly control of glycaemia and highest daily glycaemia which could potentially affect a pregnancy.
Keywords: gestational diabetespregastational diabetesthyroid gland