Diurnal blood glucose profiles in women with gestational diabetes with or without hypertension


Risto Kaaja MD PhD, Department of Obstetrics and Gynaecology, Helsinki University Hospital, Haartmanninkatu 2, 00029 HUCH, Helsinki, Finland. E-mail: risto.kaaja@huch.fi


Aim  The aim of the study was to establish whether diurnal blood glucose profiles differed in women with gestational diabetes (GDM) with different forms of hypertensive complications.

Methods  The subjects were patients diagnosed at 26–32 gestational weeks as having GDM (n = 178). They were classified as being normotensive, having chronic hypertension (with or without superimposed pre-eclampsia on chronic hypertension) or pregnancy-induced hypertension (with or without proteinuria). We compared diurnal blood glucose profiles (blood glucose taken every 4 h over 24 h) in these three groups.

Results  Hypertension complicated 43% of the women with GDM. The glucose profiles were similar between the three groups, except that in early morning hours (from 04:00 to 08:00 h) blood glucose concentrations increased in mothers with chronic hypertension, whereas they decreased in the normotensive women. In univariate regression analysis, both obesity (BMI ≥ 28 kg/m2) and chronic hypertension showed significant association with blood glucose rise from 04:00 to 08:00 h, but in a multiple regression model neither showed significant independent effect.

Conclusions  The rise in blood glucose levels during the early morning hours in women with GDM and chronic hypertension could reflect greater insulin resistance and sympathetic overactivity.