Does insulin secretion in patients with one abnormal glucose tolerance test value mimic gestational diabetes mellitus?

Ergin, Tolga; Lembet, Arda; Duran, Eyup Hakan; Kuşçu, Esra; Bağış, Tayfun; Saygılı, Esra; Batıoğlu, Sertaç

doi:10.1067/mob.2002.119634

Cited by 49 publications

(28 citation statements)

References 20 publications

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“…Indeed, high IR is considered a leading risk factor for GDM (19). Our results were in accordance with those of previous studies (20,21) on average HOMA-IS and HOMA-IR values of IGT, indicating that IGT represents an intermediate phenotype between NGT and GDM.…”

Section: B a B Asupporting

confidence: 82%

Evaluation of oral glucose tolerance test, β-cell function and adverse obstetric outcomes

et al. 2013

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Abstract. This study was conducted in order to investigate the prevalence of impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM), their effect on pregnancy and their association with adverse obstetric outcomes. A cross-sectional study was performed on 345 pregnant women, who were screened between the 24th and 28th gestational week with a 75-g oral glucose tolerance test following abnormal results at 1 h after a 50-g oral glucose challenge test. The obstetric outcomes were recorded along with plasma glucose and insulin levels, homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function index (HOMA-βCFI) and 50 subjects were excluded due to incomplete data recovery. Of the 295 pregnant women, 18.6% (55/295) were diagnosed with GDM and 32% (95/295) with IGT. The GDM group exhibited significantly higher fasting and 1-h blood glucose concentrations compared to the normal glucose tolerance (NGT) and IGT groups (P<0.01). The 2-and 3-h insulin values of the NGT group were significantly lower compared to those of the GDM group (P<0.05, P<0.01). In the IGT group, the 2-h insulin values were higher compared to the NGT group and the 3-h values were significantly higher (P<0.01), similar to the GDM group. There was a tendency for progressively decreased β-cell function and increased HOMA-IR from the NGT to the IGT to the GDM group. The adverse outcomes of pregnancy-induced hypertension, fetal distress, neonatal hyperbilirubinemia, preterm delivery, macrosomia and cesarean delivery indicated an association with HOMA-βCFI and HOMA-IR. In conclusion, these findings suggest a clinical significance of β-cell dysfunction in women with gestational IGT.

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Section: B a B Asupporting

confidence: 82%

Evaluation of oral glucose tolerance test, β-cell function and adverse obstetric outcomes

et al. 2013

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“…In women with GDM the coexistence of defects in insulin sensitivity and insulin secretion have been repeatedly demonstrated (12). On the contrary, it has not yet been fully established whether women with OAV may represent an intermediate phenotype between normal women and women with GDM, because limited data are available (13)(14)(15).…”

mentioning

confidence: 99%

Normal Glucose Tolerance and Gestational Diabetes Mellitus

et al. 2007

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OBJECTIVE -The aim of this article was to define the metabolic phenotype of pregnant women with one abnormal value (OAV) during an oral glucose tolerance test (OGTT) and to test whether OAV could be considered metabolically comparable to gestational diabetes mellitus (GDM) or a specific entity between GDM and normal pregnancy. RESEARCH DESIGN AND METHODS-After 100-g 3-h OGTTs, 4,053 pregnant women were classified as having GDM, OAV, or normal glucose tolerance (NGT). Those with OAV were subdivided into three subgroups: fasting hyperglycemia (one abnormal value at fasting during an OGTT), 1-h hyperglycemia (one abnormal value at 1 h during an OGTT [1h-OAV]), or 2-or 3-h hyperglycemia (one abnormal value at 2 or 3 h during an OGTT). As derived from the OGTT, we measured insulin sensitivity (insulin sensitivity index [ISI] Matsuda) and insulin secretion (homeostasis model assessment for the estimation of ␤-cell secretion [HOMA-B], first-and second-phase insulin secretion). The product of the first-phase index and the ISI was calculated to obtain the insulin secretion-sensitivity index (ISSI).RESULTS -GDM was diagnosed in 17.9% and OAV in 18.7% of pregnant women; women with GDM and OAV were older and had higher BMI and serum triglyceride levels than those with NGT (all P Ͻ 0.05). Women with NGT had the highest ISI followed by those with OAV (Ϫ21.7%) and GDM (Ϫ32.1%). HOMA-B results were comparable with those for OAV and GDM but significantly (P Ͻ 0.01) lower than those for NGT; first-and second-phase insulin secretion appeared progressively reduced from that in women with NGT to that in women with OAV and GDM (P Ͻ 0.01). ISSI was higher in women with NGT than in women with either OAV (Ϫ34%) or GDM (Ϫ51.7%) (P Ͻ 0.001). Among OAV subgroups, the 1h-OAV subgroup showed the lowest ISSI (P Ͻ 0.05).CONCLUSIONS -OAV and GDM are clinically indistinguishable, and both groups are different from women with NGT. Women with GDM and OAV showed impaired insulin secretion and insulin sensitivity, although these defects are more pronounced in women with GDM. Compared with other OAV subgroups, 1h-OAV could be considered a more severe condition.

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“…Pregnant women with OAV on a 100-g OGTT are connected to a higher frequency of adverse perinatal events when compared to a population with normal glucose tolerance [20,22]. The glycemic profile and characteristics of these pregnant women are similar to those of women with a diagnosis of traditional GDM.…”

Section: Discussionmentioning

confidence: 63%

“…Ergin et al investigated insulin response in 100-g OGTT [20]. They showed that the insulinogenic index was significantly lower in the traditional GDM group (two or more abnormal values on OGTT) compared with the normal OGTT group [20]. Di Cianni et al reported that pregnant women with OAV and the traditional GDM group were older and had higher BMIs than the group with normal glucose tolerance [21].…”

Section: Discussionmentioning

confidence: 99%