Tehran University Medical Journal

Background: GDM (Gestational Diabetes Mellitus) is the most important medical complication in pregnancy. Its prevalence is about 1-14 percent. It is necessary to follow up patient with GDM in order to detect any Glucose intolerance and improve their long term outcome. The aim of this research is to find the relationship between GDM and metabolic disorder (such as glucose intolerance. Lipoprotein profile disorder and androgen disorder), which are known as cardiovascular risk factors. Improvement of these agents is achieved by changing the life style.

Materials and Methods: In this study 107 patients with recent GDM were assessed 6 months after delivery. Fasting Glucose, glucose intolerance, lipid profile, and androgens were measured. Clinical and obstetrical history based on GDM recurrence, history of macrosomia, amount of insulin to control blood sugar, breastfeeding and contraception after delivery, menstrual changing, hirsutism status were assessed and analyzed statistically. (ANOVA, x2, Fisher test)

Results: The result of this study shows 19.6 percent diabetes and 15.9 percent impaired glucose tolerance test that point out significant relationship between the recurrence of GDM, obesity, macrosomia, as well as the need of more insulin in pregnancy with prevalence of Diabetes after delivery. In patents with Diabetes and IGT comparing to normal group, lipid profile disorders such as high total cholesterol, LDL cholesterol, triglyceride and low level of HDL cholesterol were seen. There was a significant relationship between diabetes after delivery and high prevalence of hypertension.

Conclusion: Considering the high prevalence of diabetes in patients with gestational diabetes and interfering of some cardiovascular risk factors. We suggest correct follow up planning of patients with GDM by health care provider after discharge, and appropriate training of biomedical personals in this field.

Background: Several randomized controlled trials have demonstrated the safety and efficacy of drug eluting stents (DES) in selected groups of patients with less complicated diabetes. We conducted this study to determine how an unselected group of diabetic patients in Iran fare following DES implantation.

Methods: Data were collected on 147 consecutive diabetic patients who underwent percutaneous coronary intervention (PCI) with the implantation of at least one DES at the Tehran Heart Center from June 2003 to September 2005. Clinical follow-up was performed by timely scheduled visits at one, four and nine months following DES implantation. Nine months of follow-up was completed for 94.5% of the patients. The primary endpoint was the occurrence of major adverse cardiac events (MACE), which include cardiac death, myocardial infarction and target vessel revascularization (TVR). In-hospital complications were the secondary endpoint.

Results: A total of 158 coronary artery lesions were treated with DES in 147 diabetic patients (mean age = 56.4±8.92 years, 57.1% were men). During the nine-month follow-up, MACE occurred in 3.4% of patients, with a myocardial infarction rate of 1.4% and TVR rate of 1.4%. Considering one patient who underwent TVR due to acute stent thrombosis following angioplasty (during hospitalization) the total number of TVR reached 3 (2%). Only one patient (0.7%) died of cardiac death, which occurred after the procedure and before discharge. In-hospital complications occurred in six patients (4.1%) five patients suffered from myocardial infarction.

Conclusions: PCI with DES seems to be safe and effective in diabetic patients. However, more studies with larger study populations and longer follow-up are required to confirm this issue.