Role of Hepatic and Renal Profile in the Development of Gestational Diabetes Mellitus

Disturbances in hepatic and renal profile are well documented in diabetic patients. Antenatal pregnant women (n=300) selected for blood sampling during the early 2ndtrimester (14–18 weeks of gestation) including 176 pregnant women with positive family history of GDM and 124 women without any history of GDM. All the subjects were followed up to the early 3rd trimester (24-28 weeks of gestation) or until the onset of GDM for second sampling. Mean values of ALP, AST and GGT were significantly higher (p<0.05), however, mean albumin was found to be significantly lower in early 2ndtrimester in those patients who subsequently developed GDM. Levels of ALT, total protein, and total bilirubin did not show significant variations in comparable groups. Uric acid levels were found to be significant in those patients who developed GDM in late trimester but creatinine levels remained almost the same in both trimesters. Among 300 patients, 58 subjects developed GDM, however, in these established cases, 27% were having positive family history while 9% presented negative family history suggesting a stronger relationship of GDM with clinical/family history of pregnant women. The results of our study indicate that abnormal liver and kidney profile namely AST, ALP, GGT, albumin and uric acid may adversely affect insulin resistance and if not controlled and treated timely may cause GDM and lead to type 2 diabetes. However, ALT, serum bilirubin, total protein and creatinine appear to have no value in GDM prediction.