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

AbstractBACKGROUND/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 ≥ 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 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.
CONCLUSIONS:
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
Topics
  • Adult
  • Cross-Sectional Studies
  • Diabetes, Gestational (metabolism)
  • Female
  • Glucose Tolerance Test
  • Humans
  • Insulin (secretion)
  • Insulin Resistance
  • Pregnancy

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