Decreased Insulin Secretion in Women with Previous Gestational Diabetes Mellitus.
10.12771/emj.2015.38.1.30
- Author:
Yoon Pyo LEE
1
;
Soo Kyung LIM
;
Ji Young CHANG
;
Eun Kyo JUNG
;
Youn I CHOI
;
Jee Young OH
;
Youngsun HONG
;
Yeon Ah SUNG
;
Hyejin LEE
Author Information
1. Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea. hyejinlee@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Gestational diabetes;
Type 2 diabetes mellitus;
Insulin-Secreting cell
- MeSH:
Cross-Sectional Studies;
Diabetes Mellitus, Type 2;
Diabetes, Gestational*;
Fasting;
Female;
Glucose;
Glucose Tolerance Test;
Humans;
Insulin Resistance;
Insulin*;
Insulin-Secreting Cells;
Parents;
Postpartum Period;
Pregnancy;
Pregnant Women;
Risk Factors
- From:The Ewha Medical Journal
2015;38(1):30-35
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVES: Gestational diabetes mellitus (GDM) affects 2%-4% of the all pregnant women, and it is a major risk factor for development of type 2 DM. We performed this cross-sectional study to determine whether there were defects in insulin secretory capacity or insulin sensitivity in women with previous GDM. METHODS: On 6-8 weeks after delivery, 75 g oral glucose tolerance test was performed in 36 women with previous GDM and 19 non-pregnant control women matched with age and weight. Intravenous glucose tolerance test was performed on 10-14 weeks after delivery. Insulin secretory capacity measured as the acute insulin response to glucose (AIRg) and insulin sensitivity as minimal model derived sensitivity index (S(I)) were obtained. AIRg x S(I) (beta-cell disposition index) was used as an index of beta-cell function. RESULTS: Women with previous GDM were classified into normal glucose tolerance (postpartum-NGT, n=19) and impaired glucose tolerance (postpartum-IGT, n=17). Postpartum fasting glucose levels were significantly higher in postpartum-IGT compared to postpartum-NGT and control (P<0.05). AIRg x S(I) was significantly lower in postpartum-IGT compared to control (P<0.05). S(I) was lower in postpartum-NGT and postpartum-IGT compared to control, but the difference did not have the statistical significance. Frequency of parental history of type 2 diabetes was significantly greater in postpartum-IGT compared to postpartum-NGT (P<0.05). CONCLUSION: Women with previous GDM showed impaired insulin secretion although their glucose tolerance states were restored to normal. It suggests impaired early insulin secretion may be a major pathophysiologic factor for development of type 2 DM, and this defect may be genetically determined.
