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Subclinical abnormalities of glucose metabolism in Brazilian women with a history of gestational diabetes mellitus.
Pimenta, Walkyria P; Calderon, Iracema M P; Cruz, Ney S; Santos, Maria Luiza; Aragon, Flávio F; Padovani, Carlos Roberto.
Afiliação
  • Pimenta WP; Division of Internal Medicine, Botucatu School of Medicine, Sao Paulo State University, Brazil. wpimenta@fmb.unesp.br
Acta Obstet Gynecol Scand ; 83(12): 1152-8, 2004 Dec.
Article em En | MEDLINE | ID: mdl-15548148
BACKGROUND: To evaluate insulin release and insulin sensitivity in women with prior gestational diabetes mellitus (GDM) to gain a better understanding of type 2 diabetes pathogenesis. METHODS: GDM women were individually matched for age, body mass index, and waist/hip ratio with those who were normal glucose tolerant in a previous pregnancy (NGT). All women presented with normal glucose tolerance. Twenty pairs were submitted to the oral glucose tolerance test (OGTT) with plasma glucose, insulin, and C-peptide determinations. Of the 20 pairs, 18 participated in hyperglycemic (10.0 mmol/l) clamp experiments with frequent plasma glucose and insulin determinations, allowing us to calculate first- and second-phase insulin release and the insulin sensitivity index. GDM and NGT women were compared using Student's t-test, the Mann-Whitney U-test, Friedman's non-parametric test, and the two proportion test for independent groups. RESULTS: GDM women showed higher glycosylated hemoglobin values; at OGTT, they showed late insulin peak with increased plasma insulin levels only during the second hour, and a similar plasma C-peptide response despite a higher plasma glucose curve; during hyperglycemic clamp procedures, they showed similar biphasic insulin release and insulin sensitivity index. Considering that a woman with previous GDM had a defect in insulin release and/or insulin sensitivity, if its magnitude was at least 25% lower than that of the matched NGT woman, 43.8% showed impairment of first-phase insulin release and 55.6% insulin resistance. CONCLUSIONS: GDM women showed some degree of glucose intolerance. It is therefore necessary to follow them for a longer time.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glicemia / Diabetes Gestacional / Intolerância à Glucose / Diabetes Mellitus Tipo 2 / Insulina Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Revista: Acta Obstet Gynecol Scand Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glicemia / Diabetes Gestacional / Intolerância à Glucose / Diabetes Mellitus Tipo 2 / Insulina Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Revista: Acta Obstet Gynecol Scand Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos