Homeostatic model assessment of beta cell function predicting abnormal oral glucose tolerance testing in pregnancy: a systematic review and meta-analysis

Ellerbrock, Jonas; Balen, Veronica A. Lopes van; Mulder, Enrique de; Aardenburg, Robert; Spaanderman, Marc E. A.

doi:10.1080/09513590.2017.1369516

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“…We considered women insulin resistant or having a low beta cell function when their HOMA-IR exceeded 1.5 multiples the mean (MoM) or their HOMA-β was below 0.5 MoM, respectively, of that of healthy non-gestational diabetic second trimester women [10,11]. Low and high insulin resistance, 0.5 and 1.5 MoM-IR, corresponded with 5.3 and 15.9, respectively, while low and high beta cell function, 0.5 and 1.5 MoM-β, corresponded with with 134 and 403, respectively.…”

Section: Biochemical Analysismentioning

confidence: 99%

Role of Beta Cell Function and Insulin Resistance in the Development of Gestational Diabetes Mellitus

et al. 2022

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Background: Gestational diabetes mellitus (GDM) is a pregnancy complication characterized by second trimester hyperglycemia. Untreated, GDM is related to an increased risk for adverse pregnancy outcomes. Both beta cell dysfunction and insulin resistance underlie impaired glucose tolerance. Understanding the dominant mechanism predisposing to GDM may be important to provide effective treatment in order to improve perinatal outcomes. We hypothesize that insulin resistance rather that beta cell dysfunction predisposes to GDM. Methods: A 75g oral glucose tolerance test (OGTT) was performed on 2112 second-trimester pregnant women to determine the relationship between insulin resistance (HOMA-IR), beta cell function (HOMA-β), and the prevalence of abnormal glucose handling. Results: High insulin resistance raised the risk of GDM (relative risk (RR) 6.1, 95% confidence interval (CI) (4.4–8.5)), as did beta cell dysfunction (RR 3.8, 95% CI (2.7–5.4)). High insulin resistance, but not beta cell function, enhances the necessity for additional glucose lowering medication on top of a low carbohydrate diet in women diagnosed with GDM. Conclusions: Both high insulin resistance and beta cell dysfunction increase the risk of GDM. As increased insulin resistance, rather than beta cell function, is related to an insufficient response to a low carbohydrate diet, we speculate that insulin sensitizers rather than insulin therapy may be the most targeted therapeutic modality in diet-insensitive GDM.

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Section: Biochemical Analysismentioning

confidence: 99%

Role of Beta Cell Function and Insulin Resistance in the Development of Gestational Diabetes Mellitus

et al. 2022

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Homeostatic model assessment of beta cell function predicting abnormal oral glucose tolerance testing in pregnancy: a systematic review and meta-analysis

Abstract: Although HOMA-β is lower in women with abnormal OGTT in pregnancy, given the high degree of heterogeneity of studies, we do not propagate HOMA-β as a sole diagnostic tool replacing OGTT to diagnose GDM.

Cited by 1 publication

References 32 publications

Role of Beta Cell Function and Insulin Resistance in the Development of Gestational Diabetes Mellitus

Role of Beta Cell Function and Insulin Resistance in the Development of Gestational Diabetes Mellitus

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