Oxidative metabolism in insulin-treated gestational diabetes mellitus

Hsu, Helen W.; Butte, Nancy F.; Wong, William W.; Moon, Jon; Ellis, Kenneth J.; Klein, Peter; Moise, Kenneth J.

doi:10.1152/ajpendo.1997.272.6.e1099

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…Note that the absolute RER values differ because of the different background diet and hence food quotient, but in each study there is no evidence for a pronounced change in RER (Heini et al, 1992;. These results have recently been supported by data from normal and gestational diabetic women studied in late gestation and again at six weeks post partum (Hsu et al, 1997). Neither group showed a signi®cant difference in RER.…”

Section: Evidence For Altered Whole-body Fuel Selection In Pregnancysupporting

confidence: 52%

Pregnancy and lactation in relation to range of acceptable carbohydrate and fat intake

Catalano

1999

Eur J Clin Nutr

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The additional energy requirements of pregnancy are needed for increases in maternal (breast, uterus and adipose) and feto-placental tissue accrued during pregnancy as well as the additional running cost of pregnancy for example increased cardiac output. Based on prospective longitudinal studies, the additional energy requirements of pregnancy range from b 500 MJ in Swedish women to net savings of approximately 50 MJ in women in The Gambia with their usual nutritional intake. In addition to the wide variation in estimated energy expenditure among various ethnic populations, there is as much as a 10 ± 20 fold range in the total energy cost of pregnancy and lactation within relatively homogenous populations. The estimates of energy intake in these studies, however, are generally less than the estimates of total energy expenditure. The discrepancy between energy intake and energy expenditure during pregnancy is most probably due to several factors including decreased maternal activity, unreliable reporting of energy intake and possibly increased metabolic ef®ciency of basal metabolic rate, thermic effect of foods and physical activity. Based on recent studies, variations in maternal pregravid glucose insulin sensitivity may account for part of the observed variability associated with maternal metabolic adaptations during pregnancy. Decreases in insulin sensitivity have a signi®cant inverse correlation with accretion of adipose tissue in early pregnancy. Likewise, there is a signi®cant inverse correlation between decreases in basal oxygen consumption with increases in endogenous glucose production. The mechanism for these changes remain speculative. Additionally, although serum leptin concentrations increase 66% in early pregnancy and are correlated with maternal fat mass and basal energy expenditure, the increases in serum leptin occur prior to any signi®cant increases in body fat or basal metabolic rate suggesting that pregnancy represents another leptin resistant state. Based on these data, speci®c recommendations for acceptable carbohydrate and fat intake during pregnancy and lactation are not possible for every woman at this time. Additional prospective studies, evaluating long-term maternal and neonatal outcome are needed before more meaningful nutritional recommendations can be proposed.

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Section: Evidence For Altered Whole-body Fuel Selection In Pregnancysupporting

confidence: 52%

Pregnancy and lactation in relation to range of acceptable carbohydrate and fat intake

Catalano

1999

Eur J Clin Nutr

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“…The only plausible explanation for this disparity could be the good glycemic control of diabetes in our study population. In fact, previous studies in well-controlled GDM reported that the whole body net carbohydrate and FA utilization did not differ significantly between the GDM patients and control subjects [26]. Other authors also reported comparable levels of maternal FAs between normal and diabetic pregnancies [27].…”

Section: Discussionmentioning

confidence: 91%

Effect of Gestational Diabetes on Circulating Levels of Maternal and Neonatal Carnitine

Agakidou¹,

Diamanti²,

Papoulidis³

et al. 2013

J Diabetes Metab

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Objectives: Free carnitine is reported to decrease in normal pregnancies whereas data on the effect of gestational diabetes mellitus (GDM) on maternal and offspring carnitine status are lacking. This study aimed to assess changes in carnitine status in mothers with GDM and the offspring. Subjects/methods:Prospective case-control study of 54 pairs of mothers -neonates (27 with GDM and 27 with normal pregnancies) and 26 non-pregnant controls. Serum glucose, lipids, and total fatty acids, blood β-hydroxybutyric acid, and whole blood carnitine were assessed in mothers before labor and neonates at birth. Carnitine was assessed in dried blood-spots on Guthrie paper using Tandem Mass Spectrometry.Results: Compared to the controls, both groups of mothers had lower free carnitine and acylcarnitine and higher triglyceride and fatty acid levels. Compared to their respective maternal group, both groups of neonates had significantly higher free carnitine and acylcarnitine and lower triglyceride and fatty acid levels. Free carnitine and acylcarnitine, were comparable between the two maternal groups, whereas they were significantly higher in neonates of GDM mothers versus healthy neonates. Conclusions:Well controlled GDM does not exacerbate changes in free carnitine, acylcarnitine, and fatty acid levels in pregnant women, albeit it is associated with increased carnitine in the newborn indicating enhanced fatty acid oxidation. The potential association of carnitine changes with macrosomia and long-term consequences in the offspring of GDM needs further investigation. increased in neonates born to mothers with uncomplicated pregnancies [6,11], whereas there are no published data on the effect of GDM on the neonatal carnitine levels. The primary aim of this study was to assess the effect of GDM on maternal and offspring's carnitine levels. In addition, we investigated the possible association between circulating carnitine levels and FA changes in the mothers and their neonates. Effect of Gestational Diabetes on Circulating Levels of Maternal and Subjects and MethodsThis is a prospective case-control study. Participants were recruited among pregnant women who attended the antenatal clinic of the 2 nd Department of Obstetrics and Gynecology of the Aristotle University of Thessaloniki, at the Hippokration General Hospital, during a twoyear period. Eligible for the study were all pregnant women with single pregnancies who had an abnormal glucose tolerance test at 26-28 weeks of gestation and no history of pre-gestational diabetes. An

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“…In overweight patients with GDM, similar rates of fasting glucose appearance are achieved, but with elevated insulin concentrations relative to pregnant control subjects [18]. Total energy expenditure, basal metabolic rate and whole-body glucose utilization did not differ between insulin-treated GDM patients and controls [17].…”

Section: Carbohydrate Metabolismmentioning

confidence: 85%

“…Basal glucose production increases similarly in patients with GDM and in control subjects throughout gestation, but in late pregnancy insulin suppression of hepatic glucose production is less in GDM patients than in controls. It was found that in women with insulin-treated GDM at 32-36 weeks of gestation the total energy expenditure, basal metabolic rate, whole-body net carbohydrate and exogenous (dietary) glucose oxidation did not differ from control subjects [17]. Basal glucose concentrations decrease with advancing gestation in women developing GDM, and although at late gestation they have increased fasting insulin levels and decreased hepatic insulin sensitivity, hepatic glucose production was found either increased or unchanged in women with GDM compared to control women.…”

Section: Carbohydrate Metabolismmentioning

confidence: 92%

Metabolic Changes in Diabetic Pregnancy

Herrera¹

2005

Frontiers in Diabetes, 2005

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During pregnancy, changes in carbohydrate, amino acid and lipid metabolism occur to ensure the continuous supply of nutrients to the fetus despite intermittent maternal food intake. While adaptations of carbohydrate and amino acid metabolism in pregnancy are reasonably well known, alterations in lipid physiology and their significance for fetal growth are still little understood. The purpose of this chapter is to review the overall metabolic changes that take place in pregnancy under normal and diabetic conditions, with special attention being given to those related to lipid metabolism. Changes Occurring in the Mother during Pregnancy Affecting Fetal GrowthThe continuous supply of metabolites derived from the maternal circulation, across the placenta, sustain fetal development. Whereas the most abundant nutrient crossing the placenta is glucose, followed by amino acids, the transfer of lipid components is limited [1]. However, lipids play a major role in fetal development, as shown by changes in their availability, such as those produced by variations in dietary fat composition, which are known to have major implications on fetal and postnatal development [2]. In addition, deviations from normal maternal plasma lipid status, such as hypercholesterolemia, can trigger pathogenic events in the fetus and may influence atherosclerosis later in life [3].During the first two thirds of pregnancy the mother develops hyperinsulinemia and normal or even enhanced insulin sensitivity [4,5], which in combination with hyperphagia and limited fetal growth allows her to store a large proportion of the nutrients she eats causing an accumulation of fat stores. During the last

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Oxidative metabolism in insulin-treated gestational diabetes mellitus

Cited by 4 publications

References 20 publications

Pregnancy and lactation in relation to range of acceptable carbohydrate and fat intake

Pregnancy and lactation in relation to range of acceptable carbohydrate and fat intake

Effect of Gestational Diabetes on Circulating Levels of Maternal and Neonatal Carnitine

Metabolic Changes in Diabetic Pregnancy

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