title: Insulin secretion and insulin resistance in Korean women with gestational diabetes mellitus and impaired glucose tolerance.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sae Jeong
authors.initials: SJ
authors.lastname: Yang
authors.forename: Tae Nyun
authors.initials: TN
authors.lastname: Kim
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Baik
authors.forename: Tae Sun
authors.initials: TS
authors.lastname: Kim
authors.forename: Kwan Woo
authors.initials: KW
authors.lastname: Lee
authors.forename: Moonsuk
authors.initials: M
authors.lastname: Nam
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Park
authors.forename: Jeong-Teak
authors.initials: JT
authors.lastname: Woo
authors.forename: Young Seol
authors.initials: YS
authors.lastname: Kim
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000378:metabolism*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D011247:Pregnancy
chemical_list: D007328:Insulin
keywords: Gestational diabetes mellitus; Gestational impaired glucose tolerance; Insulin resistance; Insulin secretion