Open AccessSubclinical abnormalities of glucose metabolism in Brazilian women with a history of gestational diabetes mellitus
Author(s) -
Pimenta Walkyria P.,
Calderon Iracema M. P.,
Cruz Ney S.,
Santos Maria Luiza,
Aragon Flávio F.,
Padovani Carlos Roberto
Publication year - 2004
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.0001-6349.2004.00444.x
Subject(s) - medicine , endocrinology , gestational diabetes , insulin , diabetes mellitus , insulin resistance , subclinical infection , glucose tolerance test , c peptide , body mass index , pregnancy , gestation , biology , genetics
Background. To evaluate insulin release and insulin sensitivity in women with prior gestational diabetes mellitus (GDM) to gain a better understanding of type 2 diabetes pathogenesis. Methods. GDM women were individually matched for age, body mass index, and waist/hip ratio with those who were normal glucose tolerant in a previous pregnancy (NGT). All women presented with normal glucose tolerance. Twenty pairs were submitted to the oral glucose tolerance test (OGTT) with plasma glucose, insulin, and C‐peptide determinations. Of the 20 pairs, 18 participated in hyperglycemic (10.0 mmol/l) clamp experiments with frequent plasma glucose and insulin determinations, allowing us to calculate first‐ and second‐phase insulin release and the insulin sensitivity index. GDM and NGT women were compared using Student's t ‐test, the Mann–Whitney U ‐test, Friedman's non‐parametric test, and the two proportion test for independent groups. Results. GDM women showed higher glycosylated hemoglobin values; at OGTT, they showed late insulin peak with increased plasma insulin levels only during the second hour, and a similar plasma C‐peptide response despite a higher plasma glucose curve; during hyperglycemic clamp procedures, they showed similar biphasic insulin release and insulin sensitivity index. Considering that a woman with previous GDM had a defect in insulin release and/or insulin sensitivity, if its magnitude was at least 25% lower than that of the matched NGT woman, 43.8% showed impairment of first‐phase insulin release and 55.6% insulin resistance. Conclusions. GDM women showed some degree of glucose intolerance. It is therefore necessary to follow them for a longer time.