| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Original Studies |
Departments of Obstetrics and Gynecology (C.H., E.S., E.A.R.) and Medicine (G.B.), and General Clinical Research Center (X.C.), Temple University School of Medicine, Philadelphia, Pennsylvania 19140
Address correspondence and requests for reprints to: Guenther Boden, M.D., Temple University Hospital, 3401 North Broad Street, Philadelphia, Pennsylvania 19140.
We have determined prehepatic insulin secretion rates (ISRs) in seven
patients with gestational diabetes mellitus (GDM) and in eight age- and
weight-matched nondiabetic pregnant women during late gestation (third
trimester) and again postpartum. Plasma glucose concentrations were
raised to 
8.9 mM with iv glucose (hyperglycemic
clamping), and ISRs were determined by deconvolution of peripheral
C-peptide concentrations using C-peptide kinetic parameters that were
obtained in every patient during late gestation and again postpartum.
Plasma insulin levels were measured by RIA with an antibody with
minimal (<0.2%) cross-reactivity with proinsulin. During late
gestation, women with GDM were more insulin resistant than nondiabetic
controls and had significantly lower ISRs (689 vs. 849
pmol/min, P < 0.05) and glucose uptake rates (30.6
vs. 49.4 µmol/kg·min, P < 0.05)
in response to hyperglycemia. Postpartum, ISRs and insulin resistance
decreased in women with GDM and controls (ISR by 43% and 43%,
respectively, and insulin resistance by 75% and 118%, respectively),
and both groups had similar ISRs (352 vs. 408 pmol/min,
nonsignificant). Women with GDM, however, continued to be more
insulin resistant than controls. In summary, patients with GDM during
late pregnancy not only had severe deficiencies in ISR but, in
addition, were more insulin resistant than controls. Postpartum,
insulin resistance and ISRs (and plasma insulin levels) improved in
both groups, and ISRs (and plasma insulin levels) were no longer
significantly different in patients with GDM and controls. Insulin
resistance, however, remained higher in women with GDM, and their
glucose uptake remained lower. We concluded that the women with GDM had
a major ß-cell defect that made it impossible for them to compensate
for their increased level of insulin resistance, which occurred during
late pregnancy.
This article has been cited by other articles:
 |
|
 |
|
  A. Lapolla, M. G. Dalfra, G. Mello, E. Parretti, R. Cioni, C. Marzari, M. Masin, A. Ognibene, G. Messeri, D. Fedele, et al. Early Detection of Insulin Sensitivity and {beta}-Cell Function with Simple Tests Indicates Future Derangements in Late Pregnancy J. Clin. Endocrinol. Metab., March 1, 2008; 93(3): 876 - 880. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Simmons, S. Eaton, J. Shaw, and P. Zimmet Self-Reported Past Gestational Diabetes Mellitus as a Risk Factor for Abnormal Glucose Tolerance Among Australian Women Diabetes Care, September 1, 2007; 30(9): 2293 - 2295. [Full Text] [PDF]
|
|
|
|
|
|
T. A. Buchanan, A. Xiang, S. L. Kjos, and R. Watanabe What Is Gestational Diabetes? Diabetes Care, July 1, 2007; 30(Supplement_2): S105 - S111. [Full Text] [PDF]
|
|
|
|
|
|
S. Lim, S. H. Choi, Y. J. Park, K. S. Park, H. K. Lee, H. C. Jang, N. H. Cho, and B. E. Metzger Visceral Fatness and Insulin Sensitivity in Women With a Previous History of Gestational Diabetes Mellitus Diabetes Care, February 1, 2007; 30(2): 348 - 353. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Zhang, S. Liu, C. G. Solomon, and F. B. Hu Dietary Fiber Intake, Dietary Glycemic Load, and the Risk for Gestational Diabetes Mellitus Diabetes Care, October 1, 2006; 29(10): 2223 - 2230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Leipold, M. Knoefler, C. Gruber, K. Klein, P. Haslinger, and C. Worda Plasminogen activator inhibitor 1 gene polymorphism and gestational diabetes mellitus. Obstet. Gynecol., March 1, 2006; 107(3): 651 - 656. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. B. Tanko, J. M. Bruun, P. Alexandersen, Y. Z. Bagger, B. Richelsen, C. Christiansen, and P. J. Larsen Novel Associations Between Bioavailable Estradiol and Adipokines in Elderly Women With Different Phenotypes of Obesity: Implications for Atherogenesis Circulation, October 12, 2004; 110(15): 2246 - 2252. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Leipold, M. Knofler, C. Gruber, P. Haslinger, D. Bancher-Todesca, and C. Worda Calpain-10 Haplotype Combination and Association With Gestational Diabetes Mellitus Obstet. Gynecol., June 1, 2004; 103(6): 1235 - 1240. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.J. Glueck, N. Goldenberg, P. Wang, M. Loftspring, and A. Sherman Metformin during pregnancy reduces insulin, insulin resistance, insulin secretion, weight, testosterone and development of gestational diabetes: prospective longitudinal assessment of women with polycystic ovary syndrome from preconception throughout pregnancy Hum. Reprod., March 1, 2004; 19(3): 510 - 521. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Sugden and M. J. Holness Potential Role of Peroxisome Proliferator-Activated Receptor-{alpha} in the Modulation of Glucose-Stimulated Insulin Secretion Diabetes, February 1, 2004; 53(90001): S71 - 81. [Abstract] [Full Text]
|
|
|
|
|
|
T. A. Buchanan, A. H. Xiang, R. K. Peters, S. L. Kjos, A. Marroquin, J. Goico, C. Ochoa, S. Tan, K. Berkowitz, H. N. Hodis, et al. Preservation of Pancreatic {beta}-Cell Function and Prevention of Type 2 Diabetes by Pharmacological Treatment of Insulin Resistance in High-Risk Hispanic Women Diabetes, September 1, 2002; 51(9): 2796 - 2803. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. N.M. Weijers, D. J. Bekedam, and Y. M. Smulders Determinants of Mild Gestational Hyperglycemia and Gestational Diabetes Mellitus in a Large Dutch Multiethnic Cohort Diabetes Care, January 1, 2002; 25(1): 72 - 77. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
