Impaired Insulin Sensitivity Tied to Worse Outcomes in GDM
HealthDay News — Among women with gestational diabetes mellitus (GDM), impaired insulin sensitivity, but not insulin secretion defects, is associated with a greater risk of adverse outcomes compared with normal glucose tolerance (NGT), according to a study published online May 13 in Diabetes Care.
Camille E. Powe, MD, from Massachusetts General Hospital in Boston, and colleagues used oral glucose tolerance test-based indices to estimate insulin sensitivity and secretion in 809 women at 24 to 30 weeks of gestation.
The researchers found that women with predominant insulin sensitivity defects (51% of GDM) had higher body mass index (BMI) and fasting glucose relative to women with NGT; they also had larger infants (P=0.001) and greater risk of GDM-associated adverse outcomes (P=0.003). These differences were independent of BMI. BMI, fasting glucose, infant birth weights, and risk of adverse outcomes were similar for women with predominant insulin secretion defects (30% of GDM) and women with NGT.
"Heterogeneity of physiologic processes underlying hyperglycemia exists among women with GDM," the authors write. "GDM with impaired insulin sensitivity confers a greater risk of adverse outcomes."