Pregnancy course in patients with comination of gestational diabetes mellitus on diet therapy and with placental insufficiency

Introduction . There are many works in the literature devoted to the study of the features of the course of gestational diabetes mellitus (GDM) in patients with placental insufficiency (PI) separately. However, with a combination of the above complications of pregnancy, there are very few studies, therefore, the problem requires detailed study. Objective . To determine the characteristics of the course of pregnancy complicated by PN and GDM on diet therapy. Materials and methods . A longitudinal cohort comparative study was conducted. The study included 120 patients in the II-III trimester of pregnancy with GDM on diet therapy. The main group consisted of 70 women whose pregnancy was complicated by sub- and decompensated forms of PI. The comparison group included 50 pregnant women without pathology of the fetoplacental complex. All patients underwent anthropometry, biochemical blood tests, with determination of the level of total protein, albumin, urea, creatinine, glucose, ALT, AST in the blood, total cholesterol, triglycerides, high, low, very low density lipoproteins, atherogenic index in the mother’s blood. Comparison of continuous quantitative data was performed using the Mann-Whitney test, which was calculated using the MedCalc 15.8 application program. The null hypothesis was rejected at p<0.05. Result . When assessing the state of carbohydrate metabolism in patients of the study group, it was found that GDM was compensated by diet therapy. The analysis of protein, carbohydrate and lipid metabolism indices, as well as the activity of key metabolic enzymes — AST and ALT — in pregnant women with PI and GDM on diet therapy showed that patients in the main group had significantly higher levels of creatinine, De Ritis coefficient and glycated hemoglobin, as well as a decrease in transaminases, cholesterol, relative to the comparison group. Conclusion . Our study demonstrated that in the metabolism of women with PN and GDM compensated by diet therapy, catabolic processes predominate, which may be an important pathogenetic unit.