Umbilical artery blood velocity waveforms were recorded by a pulsed Doppler system in the third trimester of pregnancy in 16 diabetic women (12 class B, 1 class C, 3 class D) and the waveforms were analysed for resistance index (RI = peak systolic velocity minus end diastolic velocity/peak systolic velocity). There was no significant correlation between the RI values and either serum glucose (r = 0.385) or fructosamine levels (r = 0.380). However, the RI values were raised in two cases with serum glucose levels of over 300 mg/dl. With a fall in serum glucose levels, the RI values returned to the normal range. No abnormal umbilical artery velocity waveforms were found when the serum glucose level was below 200 mg/dl.
The glucose tolerance test (GTT) was performed on 722 pregnant women to evaluate the diagnostic criteria for gestational diabetes mellitus (GDM) by the 75 g GTT. The upper limits of the normal levels of plasma glucose were defined as 100 mg/dl, 180 mg/dl and 150 mg/dl at fasting and 1 and 2 hours after glucose loads, respectively. The individuals were termed GDM if 2 or more values were greater than the upper limit at each time point. The incidence of GDM based on our criteria was 3.3% of all subjects. The insulinogenic indices were low and hemoglobin Ale levels were high in the women with GDM. The incidence of fetal and neonatal complications born to mothers with GDM was high. The patients diagnosed as GDM in the present study appeared to show certain differences in clinical features compared to pregnant women with normal glucose tolerance.
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