Abstract:
OBJECTIVE:To characterize physiologic subtypes of gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS:Insulin sensitivity and secretion were estimated in 809 women at 24-30 weeks' gestation, using oral glucose tolerance test-based indices. In women with GDM (8.3%), defects in insulin sensitivity or secretion were defined below the 25th percentile in women with normal glucose tolerance (NGT). GDM subtypes were defined based on the defect(s) present. RESULTS:Relative to women with NGT, women with predominant insulin sensitivity defects (51% of GDM) had higher BMI and fasting glucose, larger infants (birth weight z score 0.57 [-0.01 to 1.37] vs. 0.03 [-0.53 to 0.52], P = 0.001), and greater risk of GDM-associated adverse outcomes (57.6 vs. 28.2%, P = 0.003); differences were independent of BMI. Women with predominant insulin secretion defects (30% of GDM) had BMI, fasting glucose, infant birth weights, and risk of adverse outcomes similar to those in women with NGT. CONCLUSIONS:Heterogeneity of physiologic processes underlying hyperglycemia exists among women with GDM. GDM with impaired insulin sensitivity confers a greater risk of adverse outcomes.
journal_name
Diabetes Carejournal_title
Diabetes careauthors
Powe CE,Allard C,Battista MC,Doyon M,Bouchard L,Ecker JL,Perron P,Florez JC,Thadhani R,Hivert MFdoi
10.2337/dc15-2672subject
Has Abstractpub_date
2016-06-01 00:00:00pages
1052-5issue
6eissn
0149-5992issn
1935-5548pii
dc15-2672journal_volume
39pub_type
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