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ORAL GLUCOSE TOLERANCE TESTS IN PREGNANT WOMEN WITH POTENTIAL DIABETES, LATENT DIABETES AND GLYCOSURIA
Author(s) -
Campbell Norah,
Pyke D. A.,
Taylor K. W.
Publication year - 1971
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1971.tb00307.x
Subject(s) - glycosuria , pregnancy , medicine , diabetes mellitus , urine , impaired glucose tolerance , endocrinology , insulin , glucose tolerance test , physiology , obstetrics , insulin resistance , biology , genetics
Summary Oral glucose tolerance tests were performed at two stages of pregnancy and after delivery in women who were thought liable to have an abnormality of glucose tolerance, i.e. those who had a first‐degree diabetic relative, those who had given birth to an infant weighing more than 4·84 kg. (10 pounds) or a stillborn infant, those who had glucose in more than one routine urine specimen, and those who were known to have had an abnormal glucose tolerance in a previous pregnancy. Some normal pregnant women were also tested to provide a control group. In normal subjects there was a small increase in peak glucose levels at 32 weeks but not at 22 weeks. Insulin levels were higher during pregnancy than after delivery: the difference being significant at 32 weeks. In women who had a first degree diabetic relative, those who had given birth to an infant weighing more than 4·84 kg. (10 pounds) and those who had glucose in routine urine specimens in pregnancy, the mean glucose level two hours after oral glucose was significantly elevated at the 32nd week. Insulin levels differed little from the normal group, although the two‐hour level at 32 weeks tended to be higher than in the normal group. In women who had had an abnormal glucose tolerance in a previous pregnancy (latent diabetics) glucose tolerance was again markedly abnormal and this was associated with impaired insulin secretion. It is concluded that pregnancy may reveal defects in insulin secretion in women who are at risk for the development of diabetes. In the case of latent diabetes the defect is severe enough to produce a temporary diabetic state. In the other groups tested (potential diabetics) there is some evidence of a lesser defect in insulin secretion which is not severe enough to cause frank diabetes. The significance of these findings for mother and fetus is discussed.