Glucose tolerance and insulin status during pregnancy in South India : relationships to maternal and neonatal body composition

Abstract

This study was designed to test the hypothesis, that women, whose growth is impaired in early life (as evidenced by short stature, small head circumference and/or low birthweight) and who become 'fat' as adults are insulin resistant, become hyperglycaemic in pregnancy and give birth to fat, hyperinsulinaemic babies who are at increased risk of diabetes in adult life.

Overall, full-term babies in Mysore (urban India) were heavier (mean birthweight, 2956g) than those born in Pune (rural India) (2665g), but lighter than Southampton babies (3441g). Neonatal body composition was similar to that in Pune, with relative fat-sparing and decreased muscle mass.

Neonatal body composition; fatter mothers had fatter babies, taller mothers had longer babies and mothers with smaller head size had babies with smaller heads.

Babies of mothers with gestational diabetes (GDM) were significantly larger in all measurements, especially body fat. These 'macrosomic' changes were present across the range of 'normal' maternal glucose concentrations. Cord blood glucose and insulin concentrations were strongly and positively related to maternal blood glucose concentrations and to neonatal anthropometry.

In conclusion, GDM prevalence was high in this population. The highest glucose concentrations and insulin resistant indices were found in mothers with evidence of impaired growth in early life and who had become relatively fat as adults. 'Macrosomic' changes were seen across the range of 'normal' maternal glucose concentrations.

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