Exp Clin Endocrinol Diabetes 2010; 118(8): 485-489
DOI: 10.1055/s-0030-1249634
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Long Term Predictors of Post-Partum Glucose Metabolism in Women with Gestational Diabetes Mellitus

G. Seghieri1 , F. Tesi1 , A. De Bellis1 , R. Anichini1 , G. Fabbri1 , M. Seghieri1 , F. Franconi2
  • 1Department of Internal Medicine, Spedali Riuniti, Pistoia, Italy
  • 2Department of Pharmacology, University of Sassari, Italy
Further Information

Publication History

received 17.01.2010 first decision 17.01.2010

accepted 25.02.2010

Publication Date:
01 April 2010 (online)

Abstract

Aims: The question asked by this study was whether β-cell function expressed by insulin secretion/sensitivity measured during pregnancy in women with gestational diabetes (GDM) predicts post-partum long-term derangement in glucose metabolism.

Methods: Seventy-four Caucasian women with previous GDM were retested through a 75 g-2-h-OGTT after 8 [6] years (median[interquartile range]) from index pregnancy, measuring at pregnancy and follow-up insulin sensitivity, insulin secretion (1-h-incremental-insulin-area/incremental-glucose-area: ΔAUC60I/ΔAUC60G) as well as the product of Stumvoll-first-phase – secretion x insulin sensitivity (insulin-secretion-sensitivity index (ISSI).

Results: At follow-up 47 women were normotelerant to glucose and 27 had altered glucose metabolism (AGM:10 with type 2 diabetes and 17 with IGT). Women progressed to AGM had at their index pregnancy higher mean 2-h-OGTT-glucose area (1.15±0.09vs. 1.09±0.09 mol l 2-h−1;p=0.014), and lower ΔAUC60I/ΔAUC60 (median [interquantile range]) (54.4 [51.7] vs. 73.4 [60] pmol mmol−1) and ISSI (2 977 [766] vs. 3 708 [1 141]; p<0.05 for both), but similar insulin sensitivity index 2.9 [2.5]vs. 3.2 [2.2] ml min−1 m−2;p=NS). Two-h-OGTT-glucose area, or decrease in ΔAUC60I/ΔAUC60G and ISSI were significantly associated with glucose tolerance impairment and with raised adjusted risk for AGM while insulin sensitivity at pregnancy did no predict AGM development.

Conclusions: In this group of women increased post-load plasma glucose and impaired β-cell function assessed during GDM pregnancy predict long-term post-partum AGM, while insulin sensitivity measured at the same time does not.

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Correspondence

G. SeghieriMD 

Dpartment of Internal Medicine

Spedali Riuniti Viale Matteotti

9/D

51100 Pistoia

Italy

Phone: +39/0573/35 2325

Fax: +39/0573/35 3150

Email: gseghier@tin.it