title: Glycemic variability in normal glucose tolerance women with the previous gestational diabetes mellitus.
abstract: BACKGROUND
  Women with previous gestational diabetes mellitus (pGDM) and postpartum normal glucose tolerance (NGT) may carry impaired islet β cell secretion, insulin resistance and subsequent altered glucose homeostasis. And certain normoglycemic groups at risks of diabetes were presented with elevated glycemic variability. The aim of study was to investigate the glycemic variability in NGT women with pGDM.
  
  
  METHODS
  Total 48 NGT women with pGDM (pGDM group) and 48 age- and BMI-matched NGT women without pGDM (control group) were recruited in the study. Integrated β cell function was assessed with the Insulin Secretion-Sensitivity Index-2 (ISSI-2) derived from oral glucose tolerance test. All subjects were monitored using the continuous glucose monitoring system for consecutive 72 h. The multiple parameters of glycemic variability included the mean blood glucose (MBG), standard deviation of blood glucose (SDBG), mean of daily differences (MODD), mean amplitude of glycemic excursions (MAGE) and the incremental areas above preprandial glucose values (AUCpp).
  
  
  RESULTS
  The pGDM group had a higher MBG (6.5 ± 0.9 vs. 5.9 ± 0.8 mmol/L, p < 0.05), SDBG (1.3 ± 0.3 vs. 0.9 ± 0.2 mmol/L, p < 0.05), MODD (1.4 ± 0.3 vs. 1.1 ± 0.2 mmol/L, p < 0.05), MAGE (2.7 ± 0.4 vs. 1.8 ± 0.5 mmol/L, p < 0.05), and AUCpp (26.8 ± 3.4 vs. 19.2 ± 3.2 mmol/L·h, p < 0.05), when compared to the control group, and the differences remained significant after adjusting for anthropometric indices and metabolic risk factors. Islet β cell function index ISSI-2 in the pGDM group was lower than in the control group (p < 0.05). MBG, SDBG, MODD, MAGE and AUCpp were all negatively associated with ISSI-2 in the pGDM group (r = -0.31, -0.30, -0.34, -0.48 and -0.54, respectively, p < 0.05), and the correlations remained significant after adjusting for anthropometric indices and metabolic risk factors.
  
  
  CONCLUSIONS
  Normal glucose tolerance women with pGDM were presented with elevated glycemic variability, which may be associated with impaired islet β cell function.
authors.affiliation: Department of Gynaecology and obstetrics, The Second Affiliated Hospital of Nantong University, No. 6 North Hai-er-xiang Road, Nantong, 226001 China.
authors.forename: Yong-Mei
authors.initials: YM
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Nantong University, No. 6 North Hai-er-xiang Road, Nantong, 226001 China.
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Zhao
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Nantong University, No. 6 North Hai-er-xiang Road, Nantong, 226001 China.
authors.forename: Jian-Bin
authors.initials: JB
authors.lastname: Su
authors.affiliation: Department of Gynaecology and obstetrics, The Second Affiliated Hospital of Nantong University, No. 6 North Hai-er-xiang Road, Nantong, 226001 China.
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Qiao
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Nantong University, No. 6 North Hai-er-xiang Road, Nantong, 226001 China.
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Nantong University, No. 6 North Hai-er-xiang Road, Nantong, 226001 China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
authors.affiliation: Department of Clinical Laboratory, The Second Affiliated Hospital of Nantong University, No. 6 North Hai-er-xiang Road, Nantong, 226001 China.
authors.forename: Tong
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Nantong University, No. 6 North Hai-er-xiang Road, Nantong, 226001 China.
authors.forename: Jin-Feng
authors.initials: JF
authors.lastname: Chen
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Nantong University, No. 6 North Hai-er-xiang Road, Nantong, 226001 China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Nantong University, No. 6 North Hai-er-xiang Road, Nantong, 226001 China.
authors.forename: Xue-Qin
authors.initials: XQ
authors.lastname: Wang
keywords: Gestational diabetes mellitus; Glycemic variability; Normal glucose tolerance