Microvascular reactivity in women with gestational diabetes mellitus studied during pregnancy.

Aim: To compare microvascular reactivity assessed in the skin using laser Doppler fluximetry (LDF) in women with gestational diabetes mellitus (GDM) and gestational age-matched control during pregnancy.

Methods: 110 pregnant women at ~33 weeks gestation participated in the study. Skin microvascular reactivity was evaluated by LDF, at rest, during the response to brief arterial occlusion (post occlusive hyperaemic response) and during sympathetically mediated vasoconstrictor response to deep inspiratory breath hold.

Results: No statistically significant differences were found in the microvascular variables studied (resting and maximum rate flux, post-ischaemic reactive hyperaemia and deep inspiratory breath holds) between +GDM and -GDM groups women. In women with GDM there was a negative correlation between resting flux and the response to the oral glucose tolerance test (OGTT), r = -0.282 (p = 0.037). There was also a negative correlation between the response to the OGTT and the sympathetically mediated constrictor response to inspiratory breath holds (r = -.298, p = .030) but not in women with GDM (r = .102, r = .468).

Conclusion: Attenuated microvascular reactivity as an early marker of endothelial dysfunction is not present in women with GDM when assessed during pregnancy.