Delivering diabetes / iron excess in gestational diabetes mellitus

Diabetic Medicine
Volume 18 Issue 3 Page 218 - March 2001

To cite this article: T. T. Lao, P. L. Chan, K. F. Tam (2001)
Gestational diabetes mellitus in the last trimester - a feature of
maternal iron excess?
Diabetic Medicine 18 (3), 218-223.
doi:10.1046/j.1464-5491.2001.00453.x

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Original Article
Gestational diabetes mellitus in the last trimester - a feature of
maternal iron excess?
T. T. Lao, P. L. Chan and K. F. TamDepartment of Obstetrics and
Gynaecology, The University of Hong Kong, Tsan Yuk Hospital, Hong
Kong, PRC
Correspondence to: Dr Terence Lao, Department of Obstetrics and
Gynaecology, Tsan Yuk Hospital, 30 Hospital Road, Hong Kong, PRC.
Abstract
SUMMARY

Aim To determine whether non-anaemic women with gestational diabetes
mellitus (GDM) diagnosed in third trimester pregnancy have evidence of
increased iron stores compared with matched non-diabetic controls.

Methods In a prospective study, women who had antenatal booking
before 20 weeks' gestation and without anaemia or diabetes mellitus
were recruited at the time of the oral glucose tolerance test (OGTT)
at 28-31 weeks' gestation for the study of serum ferritin, iron and
transferrin concentrations. The results were blinded to the managing
obstetricians. After delivery, the records were reviewed. The cases
diagnosed as GDM were compared with a control group (two controls for
each index case matched for parity) selected at random from the at-
risk but nondiabetic cases.

Results GDM was diagnosed in 97 of the 401 women recruited. Compared
with the 194 controls, there was no difference in the weight, body
mass index, booking and third trimester haemoglobin, or third
trimester red cell indices, but concentrations of serum ferritin,
iron, transferrin saturation, and the post-natal haemoglobin were
significantly higher. On multiple regression analysis, maternal BMI
and the log-transformed ferritin concentration remained significant
determinants of the OGTT 2-h glucose value.

Conclusion The results suggest an association between increased iron
stores and glucose intolerance at the third trimester in non-anaemic
women. The role of iron excess in the pathogenesis of GDM needs to be
examined.

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