Risposta insulinemica al carico orale di glucosio nei test di screening del diabete gestazionale

Background and aims. Given that an increased peripheral insensitivity to insulin represents the primum movens of gestational diabetes, it is reasonable to suppose that the determination and evaluation of the insulinemic response to an oral glucose loading test may represent a simple, effective and low cost screening test. A method was devised which consisted in performing two assays of insulin and glycemia in venous blood; the first while fasting, the second one hour after the ingestion per os of 50 g glucose. Methods. A group of 79 pregnant women, aged between 20 and 41 years old (mean age 30.5), was tested in around the 23rd week of gestation. All women were attending the Obstetric and Gynecological Clinic at Trieste University. Results. Based on the results obtained, insulinemic parameters appear to be significantly correlated with data for the short glycemic curve according to O'Sullivan-Mahan. Conclusions. This study appears to confirm the need to include insulinemic tests as part of the new and more efficacious glucose tolerance tests and to perform prospective studies in order to identify the most reliable screening method in terms of sensitivity and specificity, also in relation to the cost-benefit ratio.