Lipid Metabolism in Gestational Diabetes

Study of Lipid Metabolism in Gestational Diabetes

The purpose of this pilot study is to determine if, during pregnancy, women with GDM have an exaggerated lipid response compared to non-gestational diabetics. If a difference is noted, further studies will explore the possibility of screening gestational diabetics during their pregnancy for hyperlipidemia to determine if prenatal screening can predict postpartum risk for hyperlipidemia. In addition the relationship, if any between maternal lipid dysfunction and placental disease will be explored.

This will be a prospective cohort study. As part of routine prenatal care, women receive a one hour glucose challenge test to screen for gestational diabetes. Those women with elevated values then require a three hour glucose tolerance test, which is a diagnostic test for gestational diabetes. All women that are scheduled to receive a three hour GTT will be identified and ask to enroll in this study. 46 women whose three hour GTT is normal and thus do not have GDM, will be compared to 46 women with an abnormal three hour GTT and thus would have the diagnosis of GDM. Enrolled women will have a lipid panel consisting of; total cholesterol, triglycerides, HDL and LDL cholesterol at the time of their fasting glucose blood sample. In addition, a repeat lipid panel will be sent at the time of the third hour sample, to assess changes, if any due to the glucose challenge. Umbilical cord blood samples will be sent in order to obtain newborn lipid profiles. Women in both the GDM and normal groups will be asked to return 6-8 weeks

Study Overview

• Status: Completed
• Conditions: Hyperlipidemia; Gestational Diabetes
• Intervention / Treatment: Other: Total Cholesterol; Other: Triglyceride; Other: HDL; Other: LDL

Detailed Description

The purpose of this pilot study is to determine if, during pregnancy, women with GDM have an exaggerated lipid response compared to non-gestational diabetics. If a difference is noted, further studies will explore the possibility of screening gestational diabetics during their pregnancy for hyperlipidemia to determine if prenatal screening can predict postpartum risk for hyperlipidemia. In addition the relationship, if any between maternal lipid dysfunction and placental disease will be explored. Subsequent studies could also explore the possible perinatal complications associated with elevated lipids and or metabolic syndrome.

C. Experimental Design, Methodology and Expected Results

Study Design:

We propose a prospective cohort design.

Study Population:

All women that are scheduled to receive a three hour GTT to rule out gestational diabetes would be identified and ask to enroll in this study. Specifically, eligible patients will be women who failed their glucose challenge test (GCT) and are scheduled for the follow-up three hour glucose tolerance test (GTT). The GCT is routinely performed among all prenatal care patients at 24-28 wks gestation. The 3 hour GTT requires patients to be fasting overnight. A fasting blood glucose is sampled, and the patients are given a 100 gram glucose drink. Serum glucose samples are then taken at one, two and three hours after the glucose loading. The "exposed" group will be defined as women diagnosed with GDM (elevated glucose values on two or more samples in the three hour GTT). The "unexposed" group will be defined as women with no abnormal glucose values in the three hour GTT.

• Study Type: Observational
• Enrollment (Actual): 106

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Springfield, Massachusetts, United States, 01199
      • Baystate Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 40 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

• Sampling Method: Non-Probability Sample

Study Population

Pregnant women

Description

Inclusion Criteria:

• Pregnancy
• Abnormal one hour glucose challenge test
• "Normal" controls group one hour test between 135 mg% and 150 mg%
• "Gestational diabetic" group with two abnormal values on a 3 hour GTT

Exclusion Criteria:

• History of diagnosis of diabetes, hypertension, heart disease or chronic renal disease
• Prior history of lipid disorder or metabolic syndrome
• Current medications thought to adversely influence glucose tolerance (i.e. prednisone or other steroids and systemic beta-mimetic drugs)
• Non-singleton pregnancy
• < 16 years of age or over 40 years of age
• Not planning to deliver at Baystate Medical Center
• Twins

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Gestational Diabetics; Patients with Gestational Diabetes	Other: Total Cholesterol; Other: Triglyceride; Other: HDL; Other: LDL
2; Normal pregnant women without gestational diabetes	Other: Total Cholesterol; Other: Triglyceride; Other: HDL; Other: LDL

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cholesterol	Cholesterol values were obtained at least 6 weeks postpartum from the gestational diabetic group and the normal controls	Postpartum

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Triglyceride Values	Triglyceride values were obtained at least 6 weeks postpartum in both the gestational diabetic group and the normal controls.	Postpartum
HDL	Triglyceride values were obtained at least 6 weeks postpartum in both the gestational diabetic group and the normal controls.	Postpartum
LDL	LDL values were obtained at least 6 weeks postpartum in both the gestational diabetic group and the normal controls.	Postpartum

Collaborators and Investigators

• Sponsor: Baystate Medical Center
• Investigators: Principal Investigator: Glenn R Markenson, MD, Baystate Medical Center

Study record dates

Study Major Dates

• Study Start: September 1, 2007
• Primary Completion (Actual): November 1, 2010
• Study Completion (Actual): November 1, 2010

Study Registration Dates

• First Submitted: September 21, 2007
• First Submitted That Met QC Criteria: September 21, 2007
• First Posted (Estimate): September 24, 2007

Study Record Updates

• Last Update Posted (Estimate): September 11, 2013
• Last Update Submitted That Met QC Criteria: July 2, 2013
• Last Verified: July 1, 2013

More Information

Terms related to this study

• Keywords: Pregnancy; Hyperlipidemia; Gestational diabetes
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Pregnancy Complications; Lipid Metabolism Disorders; Dyslipidemias; Diabetes Mellitus; Hyperlipidemias; Diabetes, Gestational; Hyperlipoproteinemias
• Other Study ID Numbers: IRB07-121