The association between hyperuricemia in first trimester and the development of gestational diabetes

Abstract

Gestational diabetes is a growing health problem in pregnancy. The prevalence has been variable from 2.2% to 8.8% and may increase to 14% depending on the ethnic mix of criteria used for diagnosis and population (Fernandez-Morera et al., 2010). The pregnancy is a physiological situation of progressive insulin resistance. Insulin resistance and impaired beta cell function, both contribute to GDM (Singh et al., 2008). Insulin resistance includes 2 main contributors, increased maternal adiposity and insulin desensitizing effect of pregnancy hormones (Di Cianni et al., 2003). GDM is associated with fetal and maternal complications. Screening, diagnosis and management of hyperglycemia are important. Screening of GDM is recommended for all women between 24-28 weeks of pregnancy. The diagnosis is based on OGTT. Dietary restriction and suitable physical exercise help in control of GDM. Fasting and post-prandial glucose testing is necessary for monitoring and guidance of therapy. When dietary measures are inadequate to achieve glycemic targets, insulin should be introduced. Oral hypoglycemic agents are not been proved to be teratogenic and their safety has not widely accepted. Elevated uric acid is accompanied with cardiovascular disease events and risk factors such as hypertension, metabolic syndrome, chronic kidney disease, obesity, and diabetes in non-pregnant adults (Feig et al., 2008). Hyperuricemia is a risk factor for developing type 2 diabetes (Dehghan et al., 2008) (Nakanishi et al., 2003).