Insulin secretion and insulin resistance in Korean women with gestational diabetes mellitus and impaired glucose tolerance.
10.3904/kjim.2013.28.3.306
- Author:
Sae Jeong YANG
1
;
Tae Nyun KIM
;
Sei Hyun BAIK
;
Tae Sun KIM
;
Kwan Woo LEE
;
Moonsuk NAM
;
Yong Soo PARK
;
Jeong Teak WOO
;
Young Seol KIM
;
Sung Hoon KIM
Author Information
1. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Gestational diabetes mellitus;
Gestational impaired glucose tolerance;
Insulin secretion;
Insulin resistance
- MeSH:
Adult;
Cross-Sectional Studies;
Diabetes, Gestational/*metabolism;
Female;
Glucose Tolerance Test;
Humans;
Insulin/*secretion;
*Insulin Resistance;
Pregnancy
- From:The Korean Journal of Internal Medicine
2013;28(3):306-313
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The aim was to compare the insulin sensitivity and secretion index of pregnant Korean women with normal glucose tolerance (NGT), gestational impaired glucose tolerance (GIGT; only one abnormal value according to the Carpenter and Coustan criteria), and gestational diabetes mellitus (GDM). METHODS: A cross-sectional study was performed with 1,163 pregnant women with positive (1-hour plasma glucose > or = 7.2 mmol/L) in a 50-g oral glucose challenge test (OGCT). The 100-g oral glucose tolerance test (OGTT) was used to stratify the participants into three groups: NGT (n = 588), GIGT (n = 294), and GDM (n = 281). RESULTS: The GDM group had higher homeostasis model assessment of insulin resistance and lower insulin sensitivity index (ISOGTT), quantitative insulin sensitivity check index, homeostasis model assessment for estimation of index beta-cell secretion (HOMA-B), first and second phase insulin secretion, and insulin secretion-sensitivity index (ISSI) than the NGT group (p < or = 0.001 for all). Moreover, the GIGT group had lower ISOGTT, HOMA-B, first and second phase insulin secretion, and ISSI than the NGT group (p < 0.001 for all). Among the GIGT subjects, the 1-hour plasma glucose abnormal levels group showed significantly greater weight gain during pregnancy and higher values in the 50-g OGCT than the other two groups. Moreover, the 1-hour and 2-hour abnormal levels groups had poorer insulin secretion status than the 3-hour abnormal levels group. CONCLUSIONS: Korean women with GDM show impairments of both insulin secretion and insulin sensitivity. In addition, GIGT is associated with both beta-cell dysfunction and insulin resistance.
