POLYCYSTIC OVARY DISEASE - A RISK FACTOR FOR GESTATIONAL DIABETES

We investigated the impact of pregestationally elevated insulin plasma levels on glycemic control in pregnant women with polycystic ovary di sease (PCOD). Twelve patients with PCOD who became pregnant within six months following evaluation of their metabolic status were the study subjects. Four were obese and six (two obese) had a hyperinsulinemic r esponse to the oral glucose tolerance test (OGTT). They were tested wi th the OGTT at 28-30 weeks of gestation. We also tested 12 normal pati ents and 10 consecutive patients with gestational diabetes; all were a t the same gestational age. Plasma levels of insulin and glucose were determined in the samples collected for a period of four hours after g lucose load (100 g). All PCOD patients significantly increased their i nsulin secretion in pregnancy. The hyperinsulinemic PCOD patients deve loped gestational diabetes (two patients) and impaired gestational glu cose tolerance (three patients). The area tinder the insulin curve was greater in PCOD patients than in control and gestational diabetes pat ients (P < .01). In spite of their large increase in insulin secretion observed during pregnancy, patients with PCOD may develop a derangeme nt of glycemic control, probably related to their pregestational insul inemic status.