The optimal control of blood glucose is associated with normal blood pressure 24 hours profile and prevention of the left ventricular remodeling in the patients with gestational diabetes mellitus
Abstract
OBJECTIVE: The aim of this study was to evaluate the impact of the optimal diabetes control on the left ventricular parameters and ambulatory blood pressure in women with gestational diabetes mellitus (GDM). METHODS: The patients with GDM were followed up according to predetermined protocol in order to optimize blood glucose and optimal weight gain.
Ambulatory blood pressure monitoring (ABPM) and transthoracal and tissue echocardiography were examined in 36th week of pregnancy. RESULTS: The age of 35 women with GDM was 33.1 +/- 3 and 30.5 +/- 4.4 years in 31 healthy control subjects (p=0.2).
Fasting plasma glucose (FPG) in the patients with GDM was 5.0 +/- 0.5 mmol/L compared to 4.6 +/- 0.3 mmol/L in control subjects (p=0.002). Average weight gain during pregnancy was significantly lower in women with GDM; 10 +/- 7.6 kg vs. 13.1 +/- 3.7 kg in healthy pregnant women (p=0.05).
No significant differences were recorded in 24 hours mean heart rate, systolic and diastolic blood pressure and number of nondippers between both groups. The significant correlation was detected between FPG and blood pressure dipping in subjects with GDM.
Interventricular septal, posterior wall and relative wall thickness of the left ventricle were significantly higher in patients with GDM comparing to healthy pregnant women but no significant differences of the left ventricular functions were recorded. CONCLUSION: The optimal control of diabetes in GDM is associated with normal 24 hours blood pressure profile and prevention of the left ventricular function changes in GDM patients.
The differences in the left ventricular walls thicknesses may be explained by metabolic changes in GDM.