Normal pregnancy- a state of insulin resistance

J Clin Diagn Res. 2014 Nov;8(11):CC01-3. doi: 10.7860/JCDR/2014/10068.5081. Epub 2014 Nov 20.

Abstract

Background: Purpose of insulin resistance (IR) adapted by mother is to deliver enough quantity of nutrients to the growing fetus. Many maternal hormones and factors play role in causation of IR during pregnancy.

Aim: The study aims at evaluating IR at different trimesters of pregnancy.

Materials and methods: Pregnant women at 1(st), 2(nd) and 3(rd) trimester were grouped into groups I, II and III respectively (n=20 in each group). Healthy non-pregnant women were taken as controls (n=30). Fasting plasma glucose (FPG) and fasting serum insulin (FSI) were measured and IR indices such as fasting glucose to insulin ratio (FGIR), quantitative insulin sensitivity check index (QUICKI), log FSI and log HOMA1-IR were calculated. The student's t-test and one way Analysis of variance (ANOVA) were used for data analysis.

Results: The mean FSI, log FSI and log HOMA 1-IR were significantly higher in 2(nd) and 3(rd) trimesters while QUICKI was significantly lower in 2(nd) and 3(rd) trimesters of pregnancy when compared with controls. Also, mean FGIR was found to be significantly lower in 3rd trimester when compared with controls.

Conclusion: As pregnancy advances, IR increases. Increased IR is associated with poor maternal and fetal outcome. Screening of all pregnancy for IR and early intervention may help to reduce the associated complications.

Keywords: Gestation; Insulin insensitivity; Log HOMA 1-IR; QUICKI; Trimester.