Insulin resistance and β-cell function influence postprandial blood glucose levels in Japanese patients with gestational diabetes mellitus.
OBJECTIVE
The aim of this study in patients with gestational diabetes mellitus (GDM) was to evaluate the relationship of insulin resistance and secretion to area-under-the-sensor glucose concentration-time curve from before to 120 min postmeal (CGM-AUC(0-120 min)) as determined with continuous glucose monitoring (CGM).


METHODS
Immunoreactive insulin and HbA1c were determined in 22 Japanese patients with GDM undergoing a 75 g oral glucose tolerance test. Patients underwent CGM within 3 weeks of receiving a diagnosis of GDM.


RESULTS
HbA1c (NGSP) was 5.5 ± 0.4%, BMI was 24.8 ± 5.3 kg/m(2), mean sensor glucose by CGM was 94.2 ± 10.3 mg/dL, standard deviation was 17.5 ± 4.4 mg/dL, and CGM-AUC(0-120 min) was 204.2 ± 23.8 h mg/dL. The insulin resistance indices the homeostasis model assessment ratio (HOMA-R), quantitative insulin sensitivity check index (QUICKI), and the Matsuda Index were correlated with CGM-AUC(0-120 min). The disposition index (DI), which was used to evaluate insulin secretion, was negatively correlated with CGM-AUC(0-120 min).


CONCLUSIONS
Not only insulin resistance but also beta cell dysfunction contributes to postprandial hyperglycemia in Japanese patients with GDM.
a Division of Diabetes , Endocrinology and Metabolism and.
Yoshiki
Y
Kusunoki
b Division of Innovative Diabetes Treatment, Department of Internal Medicine , Hyogo College of Medicine , Hyogo , Japan.
Tomoyuki
T
Katsuno
a Division of Diabetes , Endocrinology and Metabolism and.
Rie
R
Nakae
a Division of Diabetes , Endocrinology and Metabolism and.
Kahori
K
Watanabe
a Division of Diabetes , Endocrinology and Metabolism and.
Fumihiro
F
Ochi
a Division of Diabetes , Endocrinology and Metabolism and.
Masaru
M
Tokuda
a Division of Diabetes , Endocrinology and Metabolism and.
Takafumi
T
Akagami
a Division of Diabetes , Endocrinology and Metabolism and.
Masayuki
M
Miuchi
a Division of Diabetes , Endocrinology and Metabolism and.
Jun-ichiro
J
Miyagawa
a Division of Diabetes , Endocrinology and Metabolism and.
Mitsuyoshi
M
Namba
D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000097:blood*; D005260:Female; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D050417:Insulin-Secreting Cells / Q000502:physiology*; D007564:Japan; D019518:Postprandial Period; D011247:Pregnancy
D001786:Blood Glucose; D006442:Glycated Hemoglobin
75 g oral glucose tolerance test; continuous glucose monitoring; gestational diabetes mellitus; insulin resistance; β-Cell function