Korean J Intern Med.
2013 May;28(3):306-313. 10.3904/kjim.2013.28.3.306.
Insulin secretion and insulin resistance in Korean women with gestational diabetes mellitus and impaired glucose tolerance
- Affiliations
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- 1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
- 2Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
- 3Department of Medicine, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea. hoonie.kim@cgh.co.kr
- 4Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
- 5Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
- 6Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
- 7Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
- KMID: 1776452
- DOI: http://doi.org/10.3904/kjim.2013.28.3.306
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.
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