Research work demonstrating the vital role of insulin in pregnancy

1. BLOOD GLUCOSE LEVELS AND URINALYSIS IN THE THREE
TRIMESTERS OF PREGNANCY
BY:
ODURUKWE PAMELA CHIDERA
BMS1001272
DEPARTMENT OF PHYSIOLOGY
SCHOOL OF BASIC MEDICAL SCIENCES
UNIVERSITY OF BENIN
BENIN CITY
EDO STATE.
SUPERVISED BY:
PROF. V. I. IYAWE
DECEMBER, 2014.

2. INTRODUCTION
 Pregnancy is the maternal condition of having a developing
feotus in the body. It is associated with significant changes in
the maternal physiology and anatomy (Alan and Laureen,
2003).
 Blood glucose regulation is significantly altered during
pregnancy by several modulators which brings about insulin
resistance (Connolly et al., 2000; Davy and Hambling, 2001).
 The normal blood glucose level in the healthy, non
diabetic, adult individuals ranges from 70-90mg/dl in the
fasting state and up to 140mg/dl after meals (Attah, 2002;
Vasudevan and Sreekumari, 2010).

3.  The optimal glucose levels in pregnant women ranges
between 79.2 and 99 mg/dl (Davy and Hambling, 2001;
Afolabi et al., 2003).
 A high increase in blood glucose levels in pregnancy, could
lead to gestational diabetes mellitus (Green and Stephen
2002; Afolabi et al., 2003; Mark, 2007).
 Urinalysis is an array of tests preformed on urine. It is one
of the most common methods of medical diagnosis
(Simerville et al., 2005; Patel, 2006). Some of the evaluated
parameters in urine includes glucose, protein, amongst
others.
INTRODUCTION CONTINUED….

4. AIM
This study aims at comparing fasting blood glucose
levels and assessing the urine contents in pregnant
women in the three trimesters of pregnancy using non
pregnant women as the control group.
OBJECTIVES
To compare the changes in fasting blood glucose
levels between the pregnant and non pregnant
women.
To ascertain if these changes in blood glucose
affected the renal handling of urine constituents

5. MATERIALS AND METHOD
Materials used includes:
Glucometer Kit
Universal container
Methylated spirit
Cotton wool
Medi-Test Combi 9
Handgloves
Lancets
Bathroom scale HANA BR-9011
Standard standiometer.

6. STUDY DESIGN
 120 healthy women were recruited for the study.
 4 groups, (n=30). Group 1 served as the control group
recruited from the University of Benin. Group 2,3,4
represented women in the 1st, 2nd and 3rd trimester of
pregnancy from pregnant women referred for antenatal care
in St. Philomena’s Hospital, Benin City.
 All study subjects had no family history of diabetes,
gestational diabetes, were between the ages of 20-35 and
were willing and able to fast through the night till 8am.
 The demographic characteristics and midwifery information
were collected by questionnaire after obtaining approval
from the ethical committee .

7. METHOD
 Each subject was pricked on the thumb with a sterilized
lancet and a drop of blood was placed on the glucose test strip
inserted into the glucometer which produced a reading. The
reading was recorded.
 Urine samples were collected into a universal container from
the same subjects and were assayed within 30minutes of
collection using the combi 9 test strip. The colour change on
the test strip was compared to the standard colour chart to
determine thechemical properties in the urine.

8. STATISTICAL ANALYSIS
Data analysis and graphs were done using microcal origin
5.0. One-way Anova was used to compare means. Data are
presented as means ± SEM. P- values of less than 0.05 (P <
0.05) was considered statistically significant.

9. CHANGES IN BODY MASS INDEX (BMI) IN THE 3
TRIMESTERS OF PREGNANCY
Figure i: Showing changes in body mass index in the different trimesters of
pregnancy. N= 30, Means ± SEM. P<0.05
CONTROL FIRST SECOND THIRD
0
10
20
30
40
P<0.05
BMI(Kg/M
2
)
TRIMESTER

10. CHANGES IN FASTING BLOOD GLUCOSE LEVEL IN
THE 3 TRIMESTERS OF PREGNANCY
CONTROL FIRST SECOND THIRD
0
20
40
60
80
100
120 P<0.05
FASTINGBLOODSUGARLEVEL(Mg/dl)
TRIMESTERS
Figure ii: Showing changes in fasting blood glucose levels in the different
trimesters of pregnancy. N= 30, Means ± SEM. P<0.05

11. URINALYSIS
FIRST
TRIMESTER
100%
2ND
TRIMESTER
100%
3RD
TRIMESTER
100%
CONTROL
100%
NO GLUCOSE, PROTEIN, BLOOD, NITRITE AND NORMAL
UROBILINOGEN CONTENT
Figure iii: Showing the percentage of subjects that had no glucose,
protein, blood, nitrite and a normal urobilinogen content in urine.

12. FIRST
TRIMESTER
100%
2ND
TRIMESTER
100%
3RD
TRIMESTER
75%
CONTROL
100%
KETONE CONTENT
Figure iv:
Showing the percentage of subjects that had no ketone in urine
25% of the 3rd trimester subjects were insulin resistant. As a result, traces of
ketone showed in their urine.

13. FIRST
TRIMESTER
100%
2ND
TRIMESTER
100%
3RD
TRIMESTER
80%
CONTROL
100%
BILIRUBIN CONTENT
Figure v:
Showing the percentage of subjects that had no bilirubin content in urine.
20% of the 3rd trimester subjects with bilirubin content were examined further for
bilirubinuria, a condition elicited by either a bile duct obstruction (cholestasis of
pregnancy) or a hepatic condition and usually precedes Jaundice.

14. CONCLUSION
From the study, it can be inferred that pregnancy is associated
with increase in blood glucose levels resulting from a reduction
in insulin-stimulated glucose transport caused by insulin
resistance.
Furthermore, urine constituents in the non pregnant and
pregnant woman appear to have a positive correlation except in
pathological or highly insulin resistant cases.

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