Possibilities of using different indices of insulin resistance in various subtypes of gestational diabetes mellitus

Abstract

Objective: to identify IR indices for diagnosing the GDM subtype.Materials and methods: carbohydrate metabolism (venous plasma glucose on an empty stomach, oral glucose tolerance test with 75 g of glucose with insulin determination), and lipid metabolism were assessed in 130 pregnant women. The following indices were calculated: HOMA-IR, QUICKI, Matsuda, McAuley, Belfiore, Gutt, Stumvoll, Avignon. According to the Matsuda index, patients were divided into subgroups: Group I — 45 pregnant women with GDM and β-cell dysfunction, Group II — 43 with GDM and IR, group III — 42 without GDM. Statistical processing was carried out using comparative analysis. Data are presented as medians and interquartile ranges of quantitative indicators in groups.Results: statistically significant differences in the severity of IR were obtained when calculating all indices. When calculating HOMA-IR, patients in group II showed the best results: group I [1.13 (0.85; 1.34)], group II [2.33 (1.76; 4.23)], group III [1.25 (1.01; 2.43)]. When calculating the remaining indices, differences were also revealed that demonstrate heterogeneity. Using the HOMA-B insulin secretion assessment index, it was revealed that patients with GDM without IR had the lowest score, while the results did not differ among other groups: group I [15.3 (11.1; 18.0)], group II [36.9 (19.4; 57.0)], group III [25.9 (20.4; 59.9)].Conclusion: we studied the features of IR indices in pregnant women with different subtypes of GDM. Indices have been determined that allow differentiating different subtypes of GDM.