Insulin secretion and insulin resistance in Korean women with gestational diabetes mellitus and impaired glucose tolerance.

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).
A cross-sectional study was performed with 1,163 pregnant women with positive (1-hour plasma glucose ≥ 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).
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 β-cell secretion (HOMA-B), first and second phase insulin secretion, and insulin secretion-sensitivity index (ISSI) than the NGT group (p ≤ 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.
Korean women with GDM show impairments of both insulin secretion and insulin sensitivity. In addition, GIGT is associated with both β-cell dysfunction and insulin resistance.
AuthorsSae Jeong Yang, 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
JournalThe Korean journal of internal medicine (Korean J Intern Med) Vol. 28 Issue 3 Pg. 306-13 (May 2013) ISSN: 2005-6648 [Electronic] Korea (South)
PMID23682224 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Insulin
  • Adult
  • Cross-Sectional Studies
  • Diabetes, Gestational (metabolism)
  • Female
  • Glucose Tolerance Test
  • Humans
  • Insulin (secretion)
  • Insulin Resistance
  • Pregnancy

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