Gestational diabetes & diabetes in pregnancy
Distinct Insulin Physiology Trajectories in Euglycemic Pregnancy and Gestational Diabetes Mellitus
Authors' conclusion
β-Cell function is enhanced in early pregnancy. Deficient first-trimester β-cell function predicts GDM.
Study context
- Population
- Pregnant participants with OGTTs at ≤15 weeks' gestation, 24–32 weeks' gestation and 6–24 weeks postpartum
- Participants
- 166 participants
- Exposure
- Early pregnancy and mid-late pregnancy vs postpartum; early gestational diabetes mellitus (GDM) and classic GDM vs no GDM
- Early GDMn = 21
- Classic GDMn = 24
- Outcome
- Insulin sensitivity (log Matsuda index), insulin secretory response (log Stumvoll first-phase estimate, adjusted for insulin sensitivity) and PIP index vs postpartum
Methodological detailsserial OGTTs, linear mixed models
- Serial OGTTs
- Linear mixed models
Main finding
As reported in the abstract
- Insulin sensitivity, early pregnancy vs postpartum: reduced slightly
- β = −0.20, P < 0.001
- Insulin sensitivity, mid-late pregnancy vs postpartum: reduced substantially
- β = −0.47, P < 0.001
- Insulin secretory response, early pregnancy vs postpartum: augmented
- β = 0.16, P < 0.001
- Insulin secretory response, mid-late pregnancy vs postpartum: augmented
- β = 0.16, P = 0.001
- Pregnancy insulin physiology (PIP) index, early pregnancy vs postpartum: augmented
- β = 215, P = 0.04
- PIP index, mid-late pregnancy vs postpartum: not augmented
- β = 55, P = 0.64
Observational data: associations, not effects.
Further findings
Early GDM: early pregnancy insulin sensitivity vs postpartum
- Substantial reduction in insulin sensitivity
- β = −0.59, P < 0.001
Early and classic GDM: early pregnancy insulin secretory response and PIP index vs postpartum
- No evidence of augmentation of insulin secretory response (adjusted for insulin sensitivity) or PIP index
- P > 0.1 vs. postpartum
Prediction of GDM by early pregnancy PIP index, independent of participant characteristics
- AUC without PIP index
- 0.70 (95% CI 0.61-0.79)
- AUC with PIP index
- 0.87 (95% CI 0.80-0.93)
Original publication
Distinct Insulin Physiology Trajectories in Euglycemic Pregnancy and Gestational Diabetes Mellitus. Diabetes Care. Published 4 May 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →