Iranian Journal of

---

Diabetes during pregnancy is either concurrent diabetes, diagnosed before pregnancy, or ‘gestational diabetes mellitus’ (GDM), first diagnosed in pregnancy. GDM is the commonest metabolic disorder of pregnancy, with a prevalence of one to 14 percent, depending on the reporting team. The prevalence of GDM in Tehran is 4.7%. Diabetes concurrent with pregnancy is diagnosed according to the recently revised criteria of the National Diabetes Data Group (NDDG). GDM is diagnosed with a 100-gram 3-hour glucose tolerance test (3hGTT100), with at least two abnormally high readings being required for a definite diagnosis. Screening for GDM is still a matter of dispute. Universal or selective screening? Each has its supporters. The American Diabetes Association (ADA) recommended universal screening until 1997, and this is still recommended for areas with a high prevalence of GDM. Diabetes during pregnancy has multiple potential consequences for mother and fetus fetal macrosomia being the commonest. The children of diabetic mothers are also more likely to become overweight and develop impaired glucose tolerance. ADA recommendations for glycemic control in diabetic mothers-to-be include maintaining their fasting blood glucose between 60 and 95mg/dl, and their postprandial blood glucose between 80 and 120mg/dl. Measurement of urinary ketones is recommended when the patient is on a calorie-restricted diet. Lifestyle changes are an integral part of management. Insulin requirements and calorie intake must be adjusted in line with weight gain as pregnancy progresses.

---

Background: Gestational diabetes mellitus is a common metabolic disorder in pregnancy. Low levels of sex hormone–binding globulin level (SHBG) is associated with increased insulin resistance and hyperinsulinemia. The aim of this study was comparison of SHBG levels between gestational diabetic pregnant women and normal ones.
Methods: Serum SHBG concentration were measured in 38 women with gestational diabetes and in 143 women with normal pregnancy. The levels of Insulin, C-peptide and testosterone were measured and Insulin resistance was estimated via HOMA Index. Insulin sensitivity was estimated via QUIKE Index.
Results: Serum SHBG concentrations was significantly lower in the diabetic group (P=0.015). In a logistic regression model after adjustment of age, body mass index (BMI) and number of gravid, lower than 25 percentile of SHBG was independently effective in prediction of gestational diabetes mellitus.
Conclusion: SHBG concentrations are lower in gestational diabetic pregnant women and low levels account as a predictor of gestational diabetes mellitus.