الفهرس 
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Abstract
Diabetes is a chronic illness that requires continuing medical care
and ongoing patient self-management education and support to prevent
acute complications and to reduce the risk of long-term complications.
Gestational diabetes is any degree of glucose intolerance with onset
or first recognition during pregnancy. The definition is applicable even if
‘the condition persists after pregnancy
The incidence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM can be responsible for an important proportion of adverse fetal and maternal outcomes during pregnancy, and it is associated with long-term health deterioration for both mother and child. Therefore, it is important to identify potentially modifiable risk factors for GDM.
Vitamin D deficiency during pregnancy is geographically widespread and can occur in up to 95% of pregnant women, depending on country of residence and other factors.
Accumulating evidence links vitamin D deficiency with abnormal glucose metabolism, and epidemiological studies have shown that women who develop GDM are more likely to be vitamin D deficient.
This study aimed to study the correlation between vitamin D deficiency in pregnant diabetic women and insulin resistance.
The study conducted on three groups; group (I) include 40 women with gestational diabetes, group (II) include 20 women with pre gestational
diabetes and group (III) include 20 pregnant women as normal control and
all in the third trimester.
All these groups subjected to full history taking including gestational
age, history of previous GDM, family history of diabetes and history of
maternal and neonatal complications. Then clinical examination including assessment of body mass index (BMI). Laboratory investigations were done
including complete blood count, liver and renal functions, lipid profile,
serum calcium, oral glucose tolerance test (OGTT), HbA1c, serum fasting
insulin and serum vitamin D level.
Serum insulin to assess Homeostasis model assessment (HOMA-IR), homeostatic model assessment of B cell function (HOMA-B) and QUICKI (Quantitative insulin sensitivity check index).
The result revealed that 50% of the control group had optimal level
of 25 (OH) vit D whereas 67.5% of GDM patient, 45% of diabetic patient
has severe form of vitamin D deficiency (<10 ng/ml).
In comparing the diabetic groups (gestational and pre gestational)
with control group; it was found that, there was significant increase in
systolic and diastolic blood pressure, BMI, pregnancy complications as
preeclampsia and neonatal complications as IUFD, macrosomia and polyhydraminos. And significant increase in triglycerides, total cholesterol,
LDL-cholesterol, FBS,1 hour, 2 hour, HOMA-IR and C-reactive protein, and significant decrease in serum calcium (total and ionized), QUICKI and vitamin D. There was no significant difference in relation to age, gestational age, gravity, parity, abortion, HDL and HOMA-B.