A link between relative hypoglycemia-hypoinsulinemia during oral glucose tolerance tests and intrauterine growth retardation

Langer, Oded; Damus, Karla; Maiman, Mitchell; Divon, Michael Y.; Levy, Julio L.; Bauman, William A.

doi:10.1016/s0002-9378(86)80004-7

Cited by 48 publications

(28 citation statements)

References 12 publications

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“…7 Previous studies in both animals and humans suggested that relative maternal hypoglycemia is associated with fetal growth restriction. [15][16][17][18] Our study shows that 6.3% of women react with hypoglycemia after a 100-g oral GTT. These women may do so repeatedly after heavy meals.…”

Section: Discussionmentioning

confidence: 63%

Hypoglycemia During the 100-g Oral Glucose Tolerance Test: Incidence and Perinatal Significance

Weissman

Solt

Zloczower

et al. 2005

Obstetrics & Gynecology

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Section: Discussionmentioning

confidence: 63%

Hypoglycemia During the 100-g Oral Glucose Tolerance Test: Incidence and Perinatal Significance

Weissman

Solt

Zloczower

et al. 2005

Obstetrics & Gynecology

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“…In addition, it has been observed that, post-glucose load, plasma insulin and glucose levels are lower in women with FGR fetuses than in women with a normal growing fetus (22,25,37,39).…”

mentioning

confidence: 99%

Elevated insulin sensitivity and β-cell function during pregnancy in mothers of growth-restricted newborns

Dalfrà

Pacini

Parretti

et al. 2011

American Journal of Physiology-Endocrinology and Metabolism

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The "Barker hypothesis" suggests that low birth weight might predict future risk of developing obesity, cardiovascular disease, and type 2 diabetes. Identification of the causes of fetal growth restriction (FGR) is critical for preventive and management strategies. Some studies indicate that maternal carbohydrate metabolism might be involved in FGR development. We aimed to evaluate, in a large number of normotensive pregnant women with normal glucose tolerance, the effect of insulin sensitivity and β-cell function on unexplained fetal growth. A total of 1,814 Caucasian pregnant women with normal prepregnancy body mass index were tested with a 75-g, 2-h glucose load (24-28 gestation wk). Insulin sensitivity was evaluated with fasting (QUICKI) and dynamic index (OGIS) and β-cell function with a modified insulinogenic index as ΔAUC(insulin)/ΔAUC(glucose) and disposition index. FGR was a birth weight below the 5th percentile for gestational age. FGR developed in 99 (5.5%) pregnant women that showed significantly higher QUICKI, OGIS, insulinogenic, and disposition index with respect to women with normal-weight babies (P < 0.0001). By using multiple regression analysis in the FRG group, QUICKI and OGIS appeared as significant independent variables (P < 0.0001 and P < 0.0366, respectively). We conclude that elevated insulin sensitivity seems to be one of the factors involved in determining unexplained fetal growth retardation; its assessment, even only in the fasting state, could be useful to guide any possible monitoring and therapeutic strategies to reduce fetal complications.

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“…A few studies have evaluated the effects of reactive hypoglycemia on perinatal and neonatal outcomes, with conflicting results [3,4,[23][24][25]. Pugh et al compared 436 pregnant women who developed hypoglycemia during GCT with 434 normoglycemic pregnancies, and found that the hypoglycemic patients were significantly younger, had lower pre-pregnancy body mass indices, and were more likely to develop preeclampsia than normoglycemic women [4].…”

Section: Discussionmentioning

confidence: 99%

“…Pugh et al compared 436 pregnant women who developed hypoglycemia during GCT with 434 normoglycemic pregnancies, and found that the hypoglycemic patients were significantly younger, had lower pre-pregnancy body mass indices, and were more likely to develop preeclampsia than normoglycemic women [4]. Langer et al reported an association between maternal hypoglycemia and SGA [23]. Feinberg et al found increased NICU admissions among pregnant women who experienced hypoglycemia during GCT [24].…”

Section: Discussionmentioning

confidence: 99%

Does reactive hypoglycemia during the 100 g oral glucose tolerance test adversely affect perinatal outcomes?

Delibaş¹,

Tanrıverdi²,

Çakmak³

2018

Ginekol Pol

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Objectives: To determine whether pregnant women who have reactive hypoglycemia during the 100 g oral glucose tolerance test (OGTT) are at an increased risk of poor pregnancy outcomes. Material and methods:We retrospectively analyzed perinatal data from 413 women who underwent a 3 h OGTT at 24-28 weeks of gestation and gave birth in our clinics between January 2012 and December 2014.Results: According to OGTT results, the majority of the subjects were normoglycemic (n = 316, 76.5%), while 49 (11.9%) were diagnosed with gestational diabetes, and 33 (8.0%) had single high glucose values. Reactive hypoglycemia was detected in only 15 patients (3.6%). The mean age of the women in the reactive hypoglycemia group was significantly lower than that of the women in the gestational diabetes and single high glucose value groups (26.4 ± 4.4 years, 31.4 ± 5.4 years, and 31.8 ± 4.3 years, respectively; p < 0.05). The newborns of the women in the reactive hypoglycemia group had higher rates of APGAR scores < 7, increased admission to the neonatal intensive care unit (NICU), and lower birth weights compared with the other groups (p < 0.001, p < 0.001, and p = 0.009, respectively). Conclusion:Reactive hypoglycemia during the 3 h 100 g OGTT is significantly associated with low APGAR scores, low birth weights, and prenatal admission to the NICU. Therefore, pregnant women who develop hypoglycemia during the 100 g OGTT performed at 24-28 weeks of gestation should receive attentive follow-up care to decrease the possibility of adverse perinatal outcomes.

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A link between relative hypoglycemia-hypoinsulinemia during oral glucose tolerance tests and intrauterine growth retardation

Cited by 48 publications

References 12 publications

Hypoglycemia During the 100-g Oral Glucose Tolerance Test: Incidence and Perinatal Significance

Hypoglycemia During the 100-g Oral Glucose Tolerance Test: Incidence and Perinatal Significance

Elevated insulin sensitivity and β-cell function during pregnancy in mothers of growth-restricted newborns

Does reactive hypoglycemia during the 100 g oral glucose tolerance test adversely affect perinatal outcomes?

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