Diabetes, Vol 34, Issue 9 861-869, Copyright © 1985 by American Diabetes Association

ARTICLES

Insulin resistance and impaired insulin secretion in subjects with histories of gestational diabetes mellitus

WK Ward, CL Johnston, JC Beard, TJ Benedetti, JB Halter and D Porte

NIDDM is characterized by decreased insulin secretory responses to glucose and to nonglucose stimuli, hyperglucagonemia, and decreased tissue sensitivity to insulin. However, it has been unclear which of these abnormalities, if any, precedes the others. Since women with histories of gestational diabetes mellitus (GDM) are at high risk for eventual development of NIDDM, we measured B- and A-cell function and tissue sensitivity to insulin in eight normoglycemic, postpartum women with recent histories of GDM and in eight control subjects pair-matched for age and percent of ideal body weight. Fasting plasma glucose levels in subjects with former GDM tended to be slightly higher than in matched controls (98 +/- 3 versus 92 +/- 2 mg/dl, P = 0.07). Basal plasma insulin in subjects with former GDM was significantly higher than in controls (22 +/- 4 versus 14 +/- 2 microU/ml, P = 0.05). During an intravenous glucose tolerance test (IVGTT), relative first- and second-phase insulin responses to glucose were decreased in subjects with former GDM (2316 +/- 560 versus 7798 +/- 1036% of basal X min, P = 0.004; and 8340 +/- 946 versus 14,509 +/- 2556, P = 0.04). An index of sensitivity to insulin, SI, calculated from the IVGTT, was also lower in former GDM (1.23 +/- 0.69 X 10(-4) versus 3.58 +/- 0.78 X 10(-4) min-1/microU/ml, P = 0.001). Acute insulin responses to 5 g i.v. arginine were measured at plasma glucose levels of approximately 95, 215, and 600 mg/dl. The response at 600 mg/dl is termed the AIRmax and is used as an index of glucose-regulated insulin secretory capacity.(ABSTRACT TRUNCATED AT 250 WORDS)
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				T. A. Buchanan, A. Xiang, S. L. Kjos, and R. Watanabe What Is Gestational Diabetes? Diabetes Care, July 1, 2007; 30(Supplement_2): S105 - S111. [Full Text] [PDF]

				M. Cnop, J. Vidal, R. L. Hull, K. M. Utzschneider, D. B. Carr, T. Schraw, P. E. Scherer, E. J. Boyko, W. Y. Fujimoto, and S. E. Kahn Progressive Loss of {beta}-Cell Function Leads to Worsening Glucose Tolerance in First-Degree Relatives of Subjects With Type 2 Diabetes Diabetes Care, March 1, 2007; 30(3): 677 - 682. [Abstract] [Full Text] [PDF]

				D. B. Carr, K. M. Utzschneider, R. L. Hull, J. Tong, T. M. Wallace, K. Kodama, J. B. Shofer, S. R. Heckbert, E. J. Boyko, W. Y. Fujimoto, et al. Gestational diabetes mellitus increases the risk of cardiovascular disease in women with a family history of type 2 diabetes. Diabetes Care, September 1, 2006; 29(9): 2078 - 2083. [Abstract] [Full Text] [PDF]

				J.-L. Chiasson and R. Rabasa-Lhoret Prevention of Type 2 Diabetes: Insulin Resistance and Beta-Cell Function Diabetes, December 1, 2004; 53(suppl_3): S34 - S38. [Abstract] [Full Text] [PDF]

				M. C. Sugden and M. J. Holness Potential Role of Peroxisome Proliferator-Activated Receptor-{alpha} in the Modulation of Glucose-Stimulated Insulin Secretion Diabetes, February 1, 2004; 53(90001): S71 - 81. [Abstract] [Full Text]

				A. B. Goldfine, C. Bouche, R. A. Parker, C. Kim, A. Kerivan, J. S. Soeldner, B. C. Martin, J. H. Warram, and C. R. Kahn Insulin resistance is a poor predictor of type 2 diabetes in individuals with no family history of disease PNAS, March 4, 2003; 100(5): 2724 - 2729. [Abstract] [Full Text] [PDF]

				A. Kautzky-Willer, M. Krssak, C. Winzer, G. Pacini, A. Tura, S. Farhan, O. Wagner, G. Brabant, R. Horn, H. Stingl, et al. Increased Intramyocellular Lipid Concentration Identifies Impaired Glucose Metabolism in Women With Previous Gestational Diabetes Diabetes, February 1, 2003; 52(2): 244 - 251. [Abstract] [Full Text] [PDF]

				C. Kim, K. M. Newton, and R. H. Knopp Gestational Diabetes and the Incidence of Type 2 Diabetes: A systematic review Diabetes Care, October 1, 2002; 25(10): 1862 - 1868. [Abstract] [Full Text] [PDF]

				A. Verma, C. M. Boney, R. Tucker, and B. R. Vohr Insulin Resistance Syndrome in Women with Prior History of Gestational Diabetes Mellitus J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3227 - 3235. [Abstract] [Full Text] [PDF]

				S. E. Kahn The Importance of {beta}-Cell Failure in the Development and Progression of Type 2 Diabetes J. Clin. Endocrinol. Metab., September 1, 2001; 86(9): 4047 - 4058. [Full Text] [PDF]

				T. A. Buchanan Pancreatic B-Cell Defects in Gestational Diabetes: Implications for the Pathogenesis and Prevention of Type 2 Diabetes J. Clin. Endocrinol. Metab., March 1, 2001; 86(3): 989 - 993. [Full Text]

				S. E. Kahn, R. L. Prigeon, R. S. Schwartz, W. Y. Fujimoto, R. H. Knopp, J. D. Brunzell, and D. Porte Jr. Obesity, Body Fat Distribution, Insulin Sensitivity and Islet {{beta}}-Cell Function as Explanations for Metabolic Diversity J. Nutr., February 1, 2001; 131(2): 354S - 360. [Abstract] [Full Text]

				S. L. Kjos and T. A. Buchanan Gestational Diabetes Mellitus N. Engl. J. Med., December 2, 1999; 341(23): 1749 - 1756. [Full Text] [PDF]

				J. E. Gerich The Genetic Basis of Type 2 Diabetes Mellitus: Impaired Insulin Secretion versus Impaired Insulin Sensitivity Endocr. Rev., August 1, 1998; 19(4): 491 - 503. [Abstract] [Full Text] [PDF]

				S. Zhang, A. R Folsom, J. M Flack, and K. Liu Body fat distribution before pregnancy and gestational diabetes: findings from coronary artery risk development in young adults (CARDIA) study BMJ, October 28, 1995; 311(7013): 1139 - 1140. [Full Text]

				J. W. Rich-Edwards, J. E. Manson, C. H. Hennekens, and J. E. Buring The Primary Prevention of Coronary Heart Disease in Women N. Engl. J. Med., June 29, 1995; 332(26): 1758 - 1766. [Full Text] [PDF]