Gestational diabetes & diabetes in pregnancy
Impairments of insulin and glucagon sensitivity in Chinese women with gestational diabetes mellitus
Authors' conclusion
Impairments of both insulin and glucagon sensitivity occur frequently in Chinese women with GDM, which may, individually or together, drive metabolic derangements in GDM. These observations provide new insights into the pathophysiology of GDM and support the need to target insulin or glucagon resistance, or both, in the management of GDM.
Study context
- Population
- Han Chinese pregnant women with and without gestational diabetes mellitus (GDM), 75 g oral glucose tolerance test (OGTT) at gestational weeks 24–28
- Participants
- 81 vs 81
- Comparison
- Women with GDM vs age-matched healthy controls
- GDMn = 81
- Healthy controlsn = 81reference
- Outcome
- Insulin sensitivity (HOMA-IR) and glucagon sensitivity (glucagon-alanine index)
- Follow-up
- Gestational weeks 24-28
Methodological detailsage-matched
- Age-matched
Main finding
As reported in the abstract
Correlation between homeostatic model assessment of insulin resistance (HOMA-IR) and glucagon-alanine index
r = 0.24
p = .0024
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Plasma glucose at fasting, 1 h and 2 h post-OGTTHigher in GDM | P < 0.001 each |
Discrimination of GDM from healthy participants (AUC)
- AUC, HOMA-IR + glucagon-alanine index combined
- 0.878
- AUC, HOMA-IR alone
- 0.828
- AUC, glucagon-alanine index alone
- 0.751
Insulin/glucagon sensitivity phenotypes among GDM
- Both reduced insulin and glucagon sensitivity
- 64%
- Reduced insulin sensitivity alone
- 20%
- Reduced glucagon sensitivity alone
- 14%
Correlates of HOMA-IR and glucagon-alanine index
- HOMA-IR and glucagon-alanine index correlated differentially with fasting glucose, TG, LDL-C, sum of amino acids and hepatic steatosis index
Original publication
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