Clinical Characteristics Of Pregestational Diabetes Mellitus And Gestational Diabetes Mellitus Without Diabetes History

Objective:To access the clinical differences between overt diabetes mellitus and gestational diabetes mellitus (GDM) to avoid misdiagnosis, give the patients right treatment and reduce adverse pregnancy outcome.Method:43inpatients (Jan2010to Mar2012) from the second affiliated hospital of Chongqing medical university who were used to underwent CGMS and diagnosed as GDM/overt diabetes mellitus were rediagnosed according to2012ADA standards. We comparatively analyzed the general conditions, laboratory examinations, CGMS and SMBG outcomes of the overt diabetes mellitus(n=13) and GDM (n=30) patients. Glucose measurements were divided into hypoglycemia (<3.9mmol/L), euglycemia (3.9～7.8mmol/L), hyperglycemia (>7.8mmol).Results:Overt diabetes mellitus had similar conditions of reproductive history, serum lipid with GDM. The levels of urine albumin and urine albumin to creatinine ratio (UACR) in DM group were1.9and6.3times higher than in GDM group respectively, but not statistically different.46%(6/13) DM and17%(5/30) GDM were prone to have diabetes family history. The proportion of DM who needed insulin treatment (P<0.05) was higher than of GDM. The gestation (P<0.01), HbAlc (P<0.01) were significantly different, too. The SMBG levels of average values (P<0.05), maximum values (P<0.05) in overt diabetes mellitus were significantly higher than in GDM. The CGMS levels of average blood glucose values (P <0.05), glucose area above high limit in overt diabetes mellitus were significantly higher than in GDM. The incidences of hyperglycemia, hypoglycemia were not obviously different in these two groups.Conclusion:Our study revealed overt diabetes mellitus had a higher average and max level of blood glucose, HbAlc level than GDM. Good glycemic control using CGMS/SMBG is essential for maternal and offspring’s good health. They should be treated with either diet or with additional insulin if necessary.