Research Projects

Pregnant women in India are routinely supplemented with iron as part of the Anemia Mukt Bharat program. Ferrous sulfate, and other highly bioavailable forms of iron, which are used for supplementation, can be rapidly absorbed from the intestine into the blood. In blood, iron binds with high affinity to the plasma protein, transferrin. It is known that, in patients with diabetes mellitus, transferrin is glycated. The iron-binding capacity of glycated transferrin is impaired, and this may result in elevated levels of “free” iron (also called non-transferrin-bound iron [NTBI]) in blood. NTBI is a powerful oxidant. In vitro studies have shown that NTBI can be taken up by pancreatic beta-cells, potentially subjecting them to oxidative damage. Gestational diabetes mellitus (GDM) is a condition where diabetes is diagnosed for the first time during pregnancy. We hypothesize that diabetes-induced glycation of transferrin in patients with GDM will result in elevated levels of NTBI in the blood. This may result in beta-cell damage and exacerbate glucose intolerance during pregnancy. To test this hypothesis, we propose to estimate NTBI, glycated transferrin, and other iron-related parameters (serum iron and ferritin) in pregnant women with and without GDM and correlate these with insulin secretory capacity (insulin secretion rate and disposition index) and glucose tolerance determined by oral glucose tolerance test (OGTT). In addition, levels of circulating cell-free unmethylated insulin DNA (a sensitive and specific marker of beta-cell damage) will also be estimated. We hope that the results of this study will provide more information on the effect of iron, especially NTBI, on pancreatic beta-cell function during pregnancy, an area where very little work has been done so far.