Impaired microvascular reactivity in gestational diabetes is associated with altered glycemic parameters

Objectives: To assess microvascular reactivity and glycemic parameters in GDM compared to age and GA matched controls.

Methods: This study involved 21 GDM patients and 31 controls. Microvascular reactivity was assessed using LDF and PORH. Microvascular parameters; PORH_max , PORH_peak , and time to peak perfusion (Tp) were recorded after the release of 3 minutes' upper arm occlusion. HOMA-IR was performed to evaluate insulin resistance.

Results: Average age and GA for subjects were 32.9 years and 29.2 weeks. Mean FBG and a 2-hour postprandial for GDM and controls were 4.87 ± 0.71 vs 3.99 ± 0.59 mmol/L; P < 0.001 and 9.50 ± 1.8 vs 5.67 ± 1.0 mmol/L; P < 0.001. Fasting insulin (13.88 ± 18.9 vs 8.37 ± 11.0 μLU/mL; P = 0.031) and HOMA-IR (3.14 ± 4.6 vs 1.52 ± 2.2; P = 0.004) were higher in GDM. Tp was prolonged in GDM (16.27 ± 4.3 vs 13.86 ± 2.1 seconds; P = 0.011). Positive correlations were seen between Tp and FBG and 2-hour postprandial levels.

Conclusion: Tp was prolonged in GDM compared to age-matched controls, indicating impaired microvascular reactivity.