Impaired Insulin Sensitivity Tied to Worse Outcomes in GDM

Women with predominant insulin secretion defects have outcomes similar to women with NGT
Women with predominant insulin secretion defects have outcomes similar to women with NGT

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."

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