Gestational Diabetes Clinical Trial
Official title:
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
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.
;
Observational Model: Cohort, Time Perspective: Prospective
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