Insulin secretion and insulin sensitivity in normal pregnancy and gestational diabetes mellitus

Abstract

The purpose of this study was to evaluate insulin sensitivity, beta-cell function and islet-cell-directed autoimmunity in pregnant women with normal glucose tolerance and gestational diabetes mellitus (GDM). A total of 21 women with normal glucose tolerance and 21 women with GDM were evaluated at 24-36 weeks' gestation. Insulin resistance and beta-cell function were evaluated using the continuous infusion of glucose with model assessment (CIGMA) method, which aims to give a near-physiological stimulus and to evaluate the endogenous insulin and glucose response. Islet-cell autoantibody was positive in one woman with GDM, and glutamic acid decarboxylase autoantibodies were negative in both groups. The calculated CIGMA insulin resistance (CIGMA IR) was 2.04 +/- 1.74 and 1.08 +/- 1.22 in patients with GDM and in control subjects, respectively (p < 0.05). CIGMA percentage beta-cell values were 64.04 +/- 44.55% and 87.07 +/- 52.77% in patients with GDM and control subjects, respectively (p > 0.05). Decreased insulin sensitivity in late pregnancy was more evident in lean GDM subjects with mild hyperglycemia who did not require insulin therapy, and beta-cell function was partially preserved in this group of patients.

Effects of pre-pregnancy body mass index and gestational weight gain on maternal and infant complications

“…GDM can seriously threaten the health of mothers and offspring [36]. Although the pathogenesis remains unclear, related studies have shown that insulin resistance is mainly caused by a series of physiological and pathological changes during pregnancy [37]. Adipose tissue is resistant to insulin action, resulting in lower levels of insulin receptors in fat [38,39] and the number of insulin receptors in the body gradually decreases with increasing BMI.…”

Changes of insulin resistance and β‐cell function in women with gestational diabetes mellitus and normal pregnant women during mid‐ and late pregnant period: A case–control study

“…GDM and type 2 diabetes are closely related, confer a common pathogenesis of insulin resistance and/or β‐cell function, and have been focused on worldwide because of their potential long‐term adverse effects on pregnant women and their offspring, such as obesity, metabolic syndrome, and increased risk for cardiovascular disease . Cross‐sectional studies have shown that the degree of insulin resistance increases and β‐cell function decreases in GDM patients as their pregnancy progresses . However, data on glucose metabolism among pregnant women with normal blood glucose and those with GDM are limited.…”

“…4,5 Crosssectional studies have shown that the degree of insulin resistance increases and b-cell function decreases in GDM patients as their pregnancy progresses. 6,7 However, data on glucose metabolism among pregnant women with normal blood glucose and those with GDM are limited. Most studies have evaluated insulin resistance using only fasting glucose and fasting insulin levels.…”