Insulin secretion and insulin sensitivity in normal pregnancy and gestational diabetes mellitus.
The purpose of this study was to evaluate insulin sensitivity, beta-cell function and islet-cell-directed autoimmunity in pregnant women with normal glucose tolerance and gestational diabetes mellitus (GDM). A total of 21 women with normal glucose tolerance and 21 women with GDM were evaluated at 24-36 weeks' gestation. Insulin resistance and beta-cell function were evaluated using the continuous infusion of glucose with model assessment (CIGMA) method, which aims to give a near-physiological stimulus and to evaluate the endogenous insulin and glucose response. Islet-cell autoantibody was positive in one woman with GDM, and glutamic acid decarboxylase autoantibodies were negative in both groups. The calculated CIGMA insulin resistance (CIGMA IR) was 2.04 +/- 1.74 and 1.08 +/- 1.22 in patients with GDM and in control subjects, respectively (p < 0.05). CIGMA percentage beta-cell values were 64.04 +/- 44.55% and 87.07 +/- 52.77% in patients with GDM and control subjects, respectively (p > 0.05). Decreased insulin sensitivity in late pregnancy was more evident in lean GDM subjects with mild hyperglycemia who did not require insulin therapy, and beta-cell function was partially preserved in this group of patients.
Division of Endocrinology, Department of Internal Medicine, Mersin University, Mersin, Turkey.
E
E
Akbay
M B
MB
Tiras
I
I
Yetkin
F
F
Törüner
R
R
Ersoy
S
S
Uysal
G
G
Ayvaz
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D015551:Autoimmunity; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D005865:Gestational Age; D005951:Glucose Tolerance Test; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D007515:Islets of Langerhans / Q000276:immunology / Q000503:physiopathology; D009765:Obesity / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D015430:Weight Gain
D001323:Autoantibodies; D001786:Blood Glucose; D007328:Insulin; D005968:Glutamate Decarboxylase