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Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to the postpartum period
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) a...
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| Published in: | Diabetologia 2020-02, Vol.63 (2), p.385-394 |
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| container_title | Diabetologia |
| container_volume | 63 |
| creator | 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. |
| description | 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
|
| doi_str_mv | 10.1007/s00125-019-05051-0 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7277959</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2323473975</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-85cbe15897eddca29bb4c9b7b921df19225bd511c065743d3e7b5cb24c15478e3</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhS0EokPhD7BAlth0QYqf42SDhKrykEZiAxI7y487GVdJHGynqOLP4zClUBZsbPne7xz7-iD0nJJzSoh6nQmhTDaEdg2RRNKGPEAbKjhriGDtQ7RZ-w1tt19P0JOcrwghXIrtY3TCacvqod2gH7s49aEsPkxmwO5gph4yDhPuh8XFDHiEYmwcQh7X6vc4Ql1DOeDKFVNCXHU-GAsF8iu8T3HEgymA5wT9ZCZ3g0vE5VALMZfZpLKMeIYUon-KHu3NkOHZ7X6Kvry7_Hzxodl9ev_x4u2ucUKJ0rTSWaCy7RR47wzrrBWus8p2jPo97RiT1ktKHdlKJbjnoGyVMOGoFKoFforeHH3nxY7gHUwlmUHPKYwm3ehogr7fmcJB9_FaK6ZUJ7tqcHZrkOK3pc6tx5AdDIOZIC5ZM864ULxTsqIv_0Gv4pLqH62U4LwG0_JKsSPlUsw5wf7uMZToNVt9zFbXbPWvbDWpohd_j3En-R1mBfgRyLVVc0x_7v6P7U8rP7Jh</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2343342883</pqid></control><display><type>article</type><title>Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to the postpartum period</title><source>Springer Nature</source><creator>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.</creator><creatorcontrib>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.</creatorcontrib><description><![CDATA[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
< 0.001) and was 5.49 (95% CI 2.38, 8.60) units higher at 6–12 weeks postpartum (
p
< 0.001). Compared with T1, insulin response values were 699.6 (95% CI 957.5, 441.6) units lower at T2 (
p
< 0.001) and were 356.3 (95% CI 614.3, 98.3) units lower at T3 (
p
= 0.004). Compared with T1, the DI was 6434.1 (95% CI 2486.2, 10,381.0) units higher at T2 (
p
= 0.001) and was 4262.0 (95% CI 314.6, 8209.3) units higher at T3 (
p
= 0.03). There was a decrease in mean cholesterol, triacylglycerol, LDL-cholesterol and VLDL-cholesterol from T1 to T2 (all
p
< 0.001), and an increase in mean C-reactive protein, IL-6 and IL-8 from T1 to T2 (all
p
< 0.001). Mean leptin decreased from T1 to T2 (
p
= 0.001). There was no significant change in mean adiponectin (
p
= 0.99) or TNF-α (
p
= 0.81) from T1 to T2. The mean maternal BMI decreased from T1 to T2 (
p
= 0.001) and T3 (
p
< 0.001). There were no significant correlations between any measure of change in IS
OGTT
, insulin response and DI and change in maternal cytokines, adipokines, lipids or weight from T1 to T2.
Conclusions/interpretation
In women with GDM, delivery was associated with improvement in both insulin sensitivity and insulin production within the first few days. Improvement in insulin production persisted for 6–12 weeks, but insulin sensitivity deteriorated slightly. These changes in glucose metabolism were not associated to changes in lipids, leptin, inflammation markers or body weight.
Trial registration
ClinicalTrials.gov
NCT02082301]]></description><identifier>ISSN: 0012-186X</identifier><identifier>EISSN: 1432-0428</identifier><identifier>DOI: 10.1007/s00125-019-05051-0</identifier><identifier>PMID: 31820038</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>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</subject><ispartof>Diabetologia, 2020-02, Vol.63 (2), p.385-394</ispartof><rights>This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2019</rights><rights>Diabetologia is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-85cbe15897eddca29bb4c9b7b921df19225bd511c065743d3e7b5cb24c15478e3</citedby><cites>FETCH-LOGICAL-c474t-85cbe15897eddca29bb4c9b7b921df19225bd511c065743d3e7b5cb24c15478e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31820038$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Waters, Thaddeus P.</creatorcontrib><creatorcontrib>Kim, Shin Y.</creatorcontrib><creatorcontrib>Sharma, Andrea J.</creatorcontrib><creatorcontrib>Schnellinger, Pamela</creatorcontrib><creatorcontrib>Bobo, Janet K.</creatorcontrib><creatorcontrib>Woodruff, Robert T.</creatorcontrib><creatorcontrib>Cubbins, Lisa A.</creatorcontrib><creatorcontrib>Haghiac, Mary</creatorcontrib><creatorcontrib>Minium, Judi</creatorcontrib><creatorcontrib>Presley, Larraine</creatorcontrib><creatorcontrib>Wolfe, Honor</creatorcontrib><creatorcontrib>Hauguel-de Mouzon, Sylvie</creatorcontrib><creatorcontrib>Adams, William</creatorcontrib><creatorcontrib>Catalano, Patrick M.</creatorcontrib><title>Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to the postpartum period</title><title>Diabetologia</title><addtitle>Diabetologia</addtitle><addtitle>Diabetologia</addtitle><description><![CDATA[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
< 0.001) and was 5.49 (95% CI 2.38, 8.60) units higher at 6–12 weeks postpartum (
p
< 0.001). Compared with T1, insulin response values were 699.6 (95% CI 957.5, 441.6) units lower at T2 (
p
< 0.001) and were 356.3 (95% CI 614.3, 98.3) units lower at T3 (
p
= 0.004). Compared with T1, the DI was 6434.1 (95% CI 2486.2, 10,381.0) units higher at T2 (
p
= 0.001) and was 4262.0 (95% CI 314.6, 8209.3) units higher at T3 (
p
= 0.03). There was a decrease in mean cholesterol, triacylglycerol, LDL-cholesterol and VLDL-cholesterol from T1 to T2 (all
p
< 0.001), and an increase in mean C-reactive protein, IL-6 and IL-8 from T1 to T2 (all
p
< 0.001). Mean leptin decreased from T1 to T2 (
p
= 0.001). There was no significant change in mean adiponectin (
p
= 0.99) or TNF-α (
p
= 0.81) from T1 to T2. The mean maternal BMI decreased from T1 to T2 (
p
= 0.001) and T3 (
p
< 0.001). There were no significant correlations between any measure of change in IS
OGTT
, insulin response and DI and change in maternal cytokines, adipokines, lipids or weight from T1 to T2.
Conclusions/interpretation
In women with GDM, delivery was associated with improvement in both insulin sensitivity and insulin production within the first few days. Improvement in insulin production persisted for 6–12 weeks, but insulin sensitivity deteriorated slightly. These changes in glucose metabolism were not associated to changes in lipids, leptin, inflammation markers or body weight.
Trial registration
ClinicalTrials.gov
NCT02082301]]></description><subject>Adipokines - blood</subject><subject>Adiponectin</subject><subject>Adiponectin - blood</subject><subject>Adult</subject><subject>Blood Glucose - metabolism</subject><subject>Body weight</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - metabolism</subject><subject>Cholesterol</subject><subject>Cytokines</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes, Gestational - blood</subject><subject>Diabetes, Gestational - metabolism</subject><subject>Female</subject><subject>Gestation</subject><subject>Gestational diabetes</subject><subject>Glucose metabolism</subject><subject>Glucose Tolerance Test</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Insulin</subject><subject>Insulin - blood</subject><subject>Insulin Resistance - physiology</subject><subject>Interleukin 6</subject><subject>Interleukin 8</subject><subject>Internal Medicine</subject><subject>Leptin</subject><subject>Leptin - blood</subject><subject>Lipid metabolism</subject><subject>Lipids</subject><subject>Lipoproteins (very low density)</subject><subject>Low density lipoprotein</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Metabolism</subject><subject>Postpartum</subject><subject>Postpartum Period - blood</subject><subject>Pregnancy</subject><subject>Tumor necrosis factor-α</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>0012-186X</issn><issn>1432-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kUtv1DAUhS0EokPhD7BAlth0QYqf42SDhKrykEZiAxI7y487GVdJHGynqOLP4zClUBZsbPne7xz7-iD0nJJzSoh6nQmhTDaEdg2RRNKGPEAbKjhriGDtQ7RZ-w1tt19P0JOcrwghXIrtY3TCacvqod2gH7s49aEsPkxmwO5gph4yDhPuh8XFDHiEYmwcQh7X6vc4Ql1DOeDKFVNCXHU-GAsF8iu8T3HEgymA5wT9ZCZ3g0vE5VALMZfZpLKMeIYUon-KHu3NkOHZ7X6Kvry7_Hzxodl9ev_x4u2ucUKJ0rTSWaCy7RR47wzrrBWus8p2jPo97RiT1ktKHdlKJbjnoGyVMOGoFKoFforeHH3nxY7gHUwlmUHPKYwm3ehogr7fmcJB9_FaK6ZUJ7tqcHZrkOK3pc6tx5AdDIOZIC5ZM864ULxTsqIv_0Gv4pLqH62U4LwG0_JKsSPlUsw5wf7uMZToNVt9zFbXbPWvbDWpohd_j3En-R1mBfgRyLVVc0x_7v6P7U8rP7Jh</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Waters, Thaddeus P.</creator><creator>Kim, Shin Y.</creator><creator>Sharma, Andrea J.</creator><creator>Schnellinger, Pamela</creator><creator>Bobo, Janet K.</creator><creator>Woodruff, Robert T.</creator><creator>Cubbins, Lisa A.</creator><creator>Haghiac, Mary</creator><creator>Minium, Judi</creator><creator>Presley, Larraine</creator><creator>Wolfe, Honor</creator><creator>Hauguel-de Mouzon, Sylvie</creator><creator>Adams, William</creator><creator>Catalano, Patrick M.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200201</creationdate><title>Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to the postpartum period</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-85cbe15897eddca29bb4c9b7b921df19225bd511c065743d3e7b5cb24c15478e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adipokines - blood</topic><topic>Adiponectin</topic><topic>Adiponectin - blood</topic><topic>Adult</topic><topic>Blood Glucose - metabolism</topic><topic>Body weight</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - metabolism</topic><topic>Cholesterol</topic><topic>Cytokines</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes, Gestational - blood</topic><topic>Diabetes, Gestational - metabolism</topic><topic>Female</topic><topic>Gestation</topic><topic>Gestational diabetes</topic><topic>Glucose metabolism</topic><topic>Glucose Tolerance Test</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Insulin</topic><topic>Insulin - blood</topic><topic>Insulin Resistance - physiology</topic><topic>Interleukin 6</topic><topic>Interleukin 8</topic><topic>Internal Medicine</topic><topic>Leptin</topic><topic>Leptin - blood</topic><topic>Lipid metabolism</topic><topic>Lipids</topic><topic>Lipoproteins (very low density)</topic><topic>Low density lipoprotein</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Metabolism</topic><topic>Postpartum</topic><topic>Postpartum Period - blood</topic><topic>Pregnancy</topic><topic>Tumor necrosis factor-α</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Waters, Thaddeus P.</creatorcontrib><creatorcontrib>Kim, Shin Y.</creatorcontrib><creatorcontrib>Sharma, Andrea J.</creatorcontrib><creatorcontrib>Schnellinger, Pamela</creatorcontrib><creatorcontrib>Bobo, Janet K.</creatorcontrib><creatorcontrib>Woodruff, Robert T.</creatorcontrib><creatorcontrib>Cubbins, Lisa A.</creatorcontrib><creatorcontrib>Haghiac, Mary</creatorcontrib><creatorcontrib>Minium, Judi</creatorcontrib><creatorcontrib>Presley, Larraine</creatorcontrib><creatorcontrib>Wolfe, Honor</creatorcontrib><creatorcontrib>Hauguel-de Mouzon, Sylvie</creatorcontrib><creatorcontrib>Adams, William</creatorcontrib><creatorcontrib>Catalano, Patrick M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Waters, Thaddeus P.</au><au>Kim, Shin Y.</au><au>Sharma, Andrea J.</au><au>Schnellinger, Pamela</au><au>Bobo, Janet K.</au><au>Woodruff, Robert T.</au><au>Cubbins, Lisa A.</au><au>Haghiac, Mary</au><au>Minium, Judi</au><au>Presley, Larraine</au><au>Wolfe, Honor</au><au>Hauguel-de Mouzon, Sylvie</au><au>Adams, William</au><au>Catalano, Patrick M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to the postpartum period</atitle><jtitle>Diabetologia</jtitle><stitle>Diabetologia</stitle><addtitle>Diabetologia</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>63</volume><issue>2</issue><spage>385</spage><epage>394</epage><pages>385-394</pages><issn>0012-186X</issn><eissn>1432-0428</eissn><abstract><![CDATA[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
< 0.001) and was 5.49 (95% CI 2.38, 8.60) units higher at 6–12 weeks postpartum (
p
< 0.001). Compared with T1, insulin response values were 699.6 (95% CI 957.5, 441.6) units lower at T2 (
p
< 0.001) and were 356.3 (95% CI 614.3, 98.3) units lower at T3 (
p
= 0.004). Compared with T1, the DI was 6434.1 (95% CI 2486.2, 10,381.0) units higher at T2 (
p
= 0.001) and was 4262.0 (95% CI 314.6, 8209.3) units higher at T3 (
p
= 0.03). There was a decrease in mean cholesterol, triacylglycerol, LDL-cholesterol and VLDL-cholesterol from T1 to T2 (all
p
< 0.001), and an increase in mean C-reactive protein, IL-6 and IL-8 from T1 to T2 (all
p
< 0.001). Mean leptin decreased from T1 to T2 (
p
= 0.001). There was no significant change in mean adiponectin (
p
= 0.99) or TNF-α (
p
= 0.81) from T1 to T2. The mean maternal BMI decreased from T1 to T2 (
p
= 0.001) and T3 (
p
< 0.001). There were no significant correlations between any measure of change in IS
OGTT
, insulin response and DI and change in maternal cytokines, adipokines, lipids or weight from T1 to T2.
Conclusions/interpretation
In women with GDM, delivery was associated with improvement in both insulin sensitivity and insulin production within the first few days. Improvement in insulin production persisted for 6–12 weeks, but insulin sensitivity deteriorated slightly. These changes in glucose metabolism were not associated to changes in lipids, leptin, inflammation markers or body weight.
Trial registration
ClinicalTrials.gov
NCT02082301]]></abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31820038</pmid><doi>10.1007/s00125-019-05051-0</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0012-186X |
| ispartof | Diabetologia, 2020-02, Vol.63 (2), p.385-394 |
| issn | 0012-186X 1432-0428 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7277959 |
| source | Springer Nature |
| 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 |
| title | Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to the postpartum period |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T12%3A33%3A29IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Longitudinal%20changes%20in%20glucose%20metabolism%20in%20women%20with%20gestational%20diabetes,%20from%20late%20pregnancy%20to%20the%20postpartum%20period&rft.jtitle=Diabetologia&rft.au=Waters,%20Thaddeus%20P.&rft.date=2020-02-01&rft.volume=63&rft.issue=2&rft.spage=385&rft.epage=394&rft.pages=385-394&rft.issn=0012-186X&rft.eissn=1432-0428&rft_id=info:doi/10.1007/s00125-019-05051-0&rft_dat=%3Cproquest_pubme%3E2323473975%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c474t-85cbe15897eddca29bb4c9b7b921df19225bd511c065743d3e7b5cb24c15478e3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2343342883&rft_id=info:pmid/31820038&rfr_iscdi=true |