1825-P: Reduced Insulin Clearance Compensates for Impaired ß-Cell Function to Maintain Normal Insulinemia in Normotolerant Women with History of Gestational Diabetes
| Autor: | P Lukasova, Bela Bendlova, D. Vejražková, Giovanni Pacini, Marketa Vankova, Josef Vcelak, Andrea Tura |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Complications of pregnancy business.industry Endocrinology Diabetes and Metabolism Insulin medicine.medical_treatment Insulin sensitivity Type 2 diabetes medicine.disease S cell Gestational diabetes Endocrinology Basal (medicine) Concomitant Internal medicine Internal Medicine medicine business |
| Zdroj: | Diabetes. 68 |
| ISSN: | 1939-327X 0012-1797 |
| DOI: | 10.2337/db19-1825-p |
| Popis: | Gestational diabetes (GDM) is one of the most common complications of pregnancy and it is frequently predictive of later maternal type 2 diabetes. A defect in insulin secretion is assumed to contribute to the development of GDM, which may be regarded as a prediabetic state. However, lean former GDM maintain normal insulinemia despite elevated glucose during oral test (OGTT). Aim of this study was to evaluate some of the main processes involved in glucose tolerance in a large cohort of non-obese normotolerant former GDM. A total of 721 women participated in the study: 344 with recent GDM history (FGDM, 0.5-1 year after delivery; age=34±5 years, BMI=23±4 kg/m2, HbA1c=36±5 nmol/mol) and 377 non-pregnant matching control women (32±12 years, 24±4 kg/m2, p=0.3). All underwent 75g-3h OGTT with frequent sampling for glucose, insulin and C-peptide. Insulin sensitivity (OGIS, ml/minute m2) and insulin secretion from C-peptide (CPS, nmol) were assessed through mathematical modelling and deconvolution; beta cell function (BCF) as the ratio of the areas under the curves of C-peptide and glucose; insulin clearance (INCL) as the ratio CPS/AUCINS. Data are given as mean±SD. FGDM had higher basal glucose (85±6 mg/dl vs. 82±7, p Conclusion: non-obese, normotolerant FGDM are characterized by normal insulin sensitivity and reduced B-cell function. However, a concomitant reduction of insulin clearance acts to maintain relatively normal insulin levels, which however are not sufficient to keep a lower glycemia. Disclosure G. Pacini: None. A. Tura: None. D. VejraŽková: None. P. Lukášová: None. J. Vcelák: None. M. Vanková: None. B. Bendlova: None. Funding Ministry of Health of the Czech Republic (RVO00023761) |
| Databáze: | OpenAIRE |
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