Gestational diabetes: Postpartum glucose tolerance testing

Dacus, John V.; Meyer, Norman; Muram, David; Stilson, Rebecca; Phipps, P.; Sibai, Baha M.

doi:10.1016/s0002-9378(94)70060-5

Cited by 37 publications

(18 citation statements)

References 7 publications

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“…Catalano et al reported 22% of glucose intolerance (3% diabetes, 4% IGT, 15% non-diagnostic) in their study population of predominantly white women [9]. Dacus et al also reported 15% of glucose intolerance (10% diabetes, 5% IGT) and 26% of non-diagnostic OGTT in the predominantly black women with GDM by using same diagnostic criteria [12]. The women with GDM, studied by Catalano et al, were diagnosed by the Carpenter Á/ Coustan criteria during pregnancy.…”

Section: Discussionmentioning

confidence: 88%

Gestational diabetes mellitus in Korea: prevalence and prediction of glucose intolerance at early postpartum

Jang

Yim

Han

et al. 2003

Diabetes Research and Clinical Practice

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Section: Discussionmentioning

confidence: 88%

Gestational diabetes mellitus in Korea: prevalence and prediction of glucose intolerance at early postpartum

Jang

Yim

Han

et al. 2003

Diabetes Research and Clinical Practice

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“…Human regular insulin (0.03 units/kg) was injected 20 min later over a 30-s interval. Blood was sampled 29 times over the next 180 min at an initial frequency of one sample per minute for the first 10 min and then at longer intervals as follows: 1, 2, 3, 4, 5,6,7,8,10,12,14,16,19,22,23,24,25,27,30,40, 50, 60, 70, 80, 90, 100, 120, 160, and 180 min. Bergman's minimal model was used to determine the S I , which measures the quantitative influence of insulin that enhances the fractional rate of glucose disappearance.…”

Section: Visceral Fat Measurementmentioning

confidence: 99%

Visceral Fatness and Insulin Sensitivity in Women With a Previous History of Gestational Diabetes Mellitus

et al. 2007

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OBJECTIVE -The purpose of this study was to investigate the insulin sensitivity and visceral fatness in women with previous gestational diabetes mellitus (GDM), who are prone to develop type 2 diabetes. RESEARCH DESIGN AND METHODS -A 75-g oral glucose tolerance test (OGTT) performed 1 year postpartum identified 21 GADϪ women with previous GDM and impaired glucose tolerance (GDM-IGT). Sixty age-and BMI-matched women with normal glucose tolerance (GDM-NGT) were selected by 1:3 matching to the GDM-IGT group. Another 18 women with normal glucose metabolism during a previous pregnancy and no family history of diabetes were recruited as the normal control group. Age and BMI matching was performed using a range of Ϯ1.0 years and Ϯ1.0 kg/m 2 , respectively. Total body fat was measured by tetrapolar bioelectrical impedance, and visceral fat was determined using a single cut of a computed tomography scan. Insulin sensitivity was determined by the minimal model technique using the frequently sampled intravenous glucose tolerance test.RESULTS -One year postpartum, visceral fat was greater in the GDM-IGT group than in the age-and BMI-matched GDM-NGT or normal control groups. The insulin sensitivity index was lower in the GDM-IGT group than in the GDM-NGT or normal control groups. ␤-Cell function, as measured by the acute insulin response to glucose, was also lower in GDM-IGT.CONCLUSIONS -High body fat content, especially visceral fat content, and a low insulin response to glucose seem to contribute simultaneously to the development of impaired glucose metabolism in Korean women with previous GDM. Diabetes Care 30:348 -353, 2007G estational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity first recognized in pregnancy (1). GDM may complicate as many as 5-8% of all pregnancies in North America (2). Recent reports have shown that the prevalence of GDM has been increasing in multiethnic populations (3,4). Although the reported prevalence of GDM seems to be slightly lower in Asian countries (5,6), adverse outcomes are similar in these two regions. Women with GDM have an increased risk of later development of type 2 diabetes (7). Studies in Western populations have found conversion rates of 3-38% within the 1st year postpartum (8 -10). Although a limited number of studies have been performed in Asian countries, the prevalences of impaired glucose metabolism in the early postpartum period have been reported to be 20% in Hong Kong and 38.3% in Korea (11,12).Several reports have identified clinical factors at antepartum testing or during pregnancy that predict the development of future diabetes in women with GDM. However, few reports have focused on postpartum metabolic characteristics as a risk factor for future diabetes. More than two decades ago, Ward et al. (13) showed that women with previous GDM had insulin-secretion defects and that only obese women with GDM had a lower insulin sensitivity index (S I ) and higher waist-to-hip ratio than their obese counterparts when tested postpartum. Since t...

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“…I Approximately 5% to 10% of patients continue to exhibit abnormal glucose metabolism that is below diabetic levels. 10,11 These patients are reclassified as having IFG or IGT, as appropriate. I The remainder exhibit normal glucose metabolism.…”

Section: Gestational Diabetes Mellitusmentioning

confidence: 99%