Lipid Metabolism in Gestational Diabetes
Condition: Gestational Diabetes; Hyperlipidemia
MeSH terms: Diabetes, Gestational; Diabetes Mellitus; Hyperlipidemias; Hyperlipoproteinemias
Study type: Observational

Summary: 
      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
    

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.
    

Intervention name(s): Total Cholesterol; Triglyceride; HDL; LDL
Intervention type(s): Other; Other; Other; Other
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Pregnant women
      
Keywords: Pregnancy; Gestational diabetes; Hyperlipidemia