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  • Title: Abnormal regulation of maternal cerebral blood flow under conditions of gestational diabetes mellitus.
    Author: Rosengarten B, Gruessner S, Aldinger C, Künzel W, Kaps M.
    Journal: Ultraschall Med; 2004 Feb; 25(1):34-9. PubMed ID: 14961422.
    Abstract:
    AIM: Gestational diabetes mellitus is a prediabetic state leading to endothelial dysfunction and altered organ perfusion. Under normal conditions cerebral blood flow is closely coupled to cortical activity, to which it rapidly adjusts. On the basis of this so-called neurovascular coupling we evaluated the influence of a gestational diabetic state on endothelium-dependent vasoregulative properties of this mechanism. METHOD: A functional transcranial Doppler test performed during visual stimulation was used to measure vascular reactivity. Peak systolic and end-diastolic flow velocity response from 20 non-pregnant (age 27 +/- 6 y), 31 healthy pregnant women (31 +/- 6 y; 31 +/- 4 gestational week) and 30 women with gestational diabetes (32 +/- 5 y; 34 +/- 4) were separately evaluated according to a control system approach. All women did not show any vascular risk factors prior to pregnancy. RESULTS: Comparison of resting blood flow velocity and the control system parameters of gain, attenuation, rate time and natural frequency, showed a consistent and significant difference in the parameter "attenuation" for the peak systolic data (0.55 +/- 0.18 vs. 0.44 +/- 0.1 and 0.45 +/- 0.11, p < 0.01) as well as end-diastolic (0.61 +/- 0.23 vs. 0.49 +/- 0.2 and 0.5 +/- 0.14, p < 0.05) figures (mean +/- SD of value from women with gestational diabetes vs. non-pregnant and healthy pregnant women, significance level). No differences were found between non-pregnant and normal pregnant women for the neurovascular coupling mechanism. CONCLUSIONS: Gestational diabetes mellitus results in endothelial dysfunction which can be measured in a non-invasive, painless and easy manner by a transcranial Doppler test.
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