Ventricular repolarization values and insulin resistance of diabetic mother babies in 4-6 age group

Aim: The aim of our study is to investigate the effects of maternal diabetes on insulin resistance and heart in infants. For this purpose, the HOMA index was evaluated as an indicator of insulin resistance in children aged 4-6 years of diabetic mothers. Although there are studies on the cardiac anatomy of the infant of gestational diabetes, there are less studies on its effect on electrical activity. We believe that the data obtained from the study will contribute to early detection of fatal arrhythmias secondary to insulin resistance and taking preventive measures. Material and Method: Insulin resistance and ventricular repolarization values of the babies of diabetic mothers who gave birth between 2014-2016 in Abant Izzet Baysal University Faculty of Medicine at the ages of 4-6 were evaluated. A detailed history was taken from the patients who accepted to participate in the study and informed consents were obtained, and a physical examination was performed, glucose and insulin blood levels were checked and ECGs were taken. ECGs of all participants were evaluated by a cardiologist in our hospital. In our study, Tp-e, QT, QTc, Tp-e / QT and Tp-e / QTc values were examined. HOMA-IR values and insulin resistance were evaluated. Results: Thirty-four babies of mothers with gestational diabetes and 25 healthy subjects aged 4-6 years were included in the study. There was no significant difference in gender, age, height, body weight, waist circumference and BMI percentiles of both groups. When the GDM group was compared with the control group in terms of ECG parameters, Pmax (p = 0.007), Pdisp (p = 0.026), QRS duration (p = 0.022) values were significant; Borderline significant at JTc (p = 0.07) value; QTd (p <0.001) and QTdc (p <0.001) and a significant difference was found. The group with GDM was separated as regulated by insulin and diet and compared in terms of ECG parameters, with QTd (p = 0.08) and QTdc (p = 0.06), and a borderline significance difference was found. In terms of insulin resistance, when the diet-regulated group is compared with the control group, the difference between the mean Homa - IR values is borderline significant (p = 0.097). The Pmin value of the children of pregnant women who were regulated with insulin was significantly higher than the control group (p <0.001), while the Pdisp and QRS duration were significantly higher in the control group (p <0.001). QTc, QTdc, Tpe, Tpe / QTort and Tpe / JT values were found to be significantly higher in the insulin-using group compared to the control group (p = 0.012; p = 0.023; p = 0.007; p = 0.008; p = 0.014, respectively). We obtained similar results to the insulin group in the comparison of the children of pregnant women who were diet regulated with the control group. Pdisp was found to be significantly higher in the control group (p <0.001). Pmin, QTmin, QTort, QTc, JT, JTc, Tpe, Tpe / QTort and Tpe / QTc values of the children of pregnant women who were diet-regulated were found to be significantly higher in the insulin group compared to the control group (p <0.001, p = 0.007; p = 0.047; p = 0.056; p = 0.005; p = 0.023; p = 0.002; p = 0.002; p = 0.014; p = 0.058). Conclusion: Gestational diabetes can cause life-threatening ventricular arrhythmias by affecting electrical activity as well as anatomical effects on the infant heart. Early detection of these can reduce the frequency of sudden cardiac death. Keywords: Gestational diabetes, insulin resistance, Tpe, JTc, ventricular repolarization, arrhythmia, infant of diabetic mother