Ewha Med J.  2015 Mar;38(1):30-35. 10.12771/emj.2015.38.1.30.

Decreased Insulin Secretion in Women with Previous Gestational Diabetes Mellitus

• Lee YP
• Lim SK
• Chang JY
• Jung EK
• Choi YI
• Oh JY
• Hong Y
• Sung YA
• Lee H

• KMID: 2171326
• DOI: http://doi.org/10.12771/emj.2015.38.1.30

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.

Keyword

Gestational diabetes; Type 2 diabetes mellitus; Insulin-Secreting cell

MeSH Terms

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
Glucose
Insulin

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