Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to the postpartum period

• Published in: Diabetologia 2020-02, Vol.63 (2), p.385-394
• Main Authors: Waters, Thaddeus P., Kim, Shin Y., Sharma, Andrea J., Schnellinger, Pamela, Bobo, Janet K., Woodruff, Robert T., Cubbins, Lisa A., Haghiac, Mary, Minium, Judi, Presley, Larraine, Wolfe, Honor, Hauguel-de Mouzon, Sylvie, Adams, William, Catalano, Patrick M.
• Format: Article
• Language: English
• Subjects: Adipokines - blood; Adiponectin; Adiponectin - blood; Adult; Blood Glucose - metabolism; Body weight; C-reactive protein; C-Reactive Protein - metabolism; Cholesterol; Cytokines; Diabetes; Diabetes mellitus; Diabetes, Gestational - blood; Diabetes, Gestational - metabolism; Female; Gestation; Gestational diabetes; Glucose metabolism; Glucose Tolerance Test; Human Physiology; Humans; Insulin; Insulin - blood; Insulin Resistance - physiology; Interleukin 6; Interleukin 8; Internal Medicine; Leptin; Leptin - blood; Lipid metabolism; Lipids; Lipoproteins (very low density); Low density lipoprotein; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolism; Postpartum; Postpartum Period - blood; Pregnancy; Tumor necrosis factor-α; Womens health; Young Adult
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-019-05051-0

Aims/hypothesis This study aimed to determine, in women with gestational diabetes (GDM), the changes in insulin sensitivity (Matsuda Insulin Sensitivity Index; IS OGTT ), insulin response and disposition index (DI) from late pregnancy (34–37 weeks gestation, T1), to early postpartum (1–5 days, T2) and late postpartum (6–12 weeks, T3). A secondary aim was to correlate the longitudinal changes in maternal lipids, adipokines, cytokines and weight in relation to the changes in IS OGTT , insulin response and DI. Methods IS OGTT , insulin response and DI were calculated at the three time points (T1, T2 and T3) using the results of a 75 g OGTT. Adipokines, cytokines and lipids were measured prior to each OGTT. Linear mixed-effects models were used to compare changes across each time point. Changes in IS OGTT , insulin response and DI were correlated with changes in maternal adipokines, cytokines and lipids at each time point. Results A total of 27 women completed all assessments. Compared with T1, IS OGTT was 11.20 (95% CI 8.09, 14.31) units higher at 1–5 days postpartum ( p