Perinatal and postpartum insulin secretion capacity in women with early-onset and late-onset gestational diabetes.

IF 4.1 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Akihiro Katayama, Momoka Hasegawa, Eisaku Morimoto, Mayu Watanabe, Yuichi Matsushita, Masaya Takeda, Kenji Kai, Mizuho Yoshida, Saya Tsukahara, Naoki Okimoto, Katsuhiko Tada, Kazumasa Kumazawa, Kazuyuki Hida
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Abstract

Introduction: Gestational diabetes mellitus (GDM) is associated with metabolic risks and adverse maternal and fetal perinatal outcomes. This study aimed to compare pregnancy outcomes, postpartum glucose intolerance and insulin secretion capacity in women with early-onset GDM (EGDM, diagnosed<24 weeks) and late GDM (LGDM, diagnosed≥24 weeks) in Japan.

Research design and methods: This single-center, retrospective study included 107 women with EGDM and 109 with LGDM. GDM was diagnosed through the 75 g oral glucose tolerance test. Postpartum glucose tolerance was assessed 4-16 weeks post partum. Maternal and neonatal outcomes, insulin secretion, and postpartum glucose tolerance were analyzed and compared. Subgroup analyses were performed for women with and without obesity.

Results: Although gestational weight gain was significantly lower in women with EGDM than in those with LGDM, pregnancy outcomes, including neonatal birth weight, small for gestational age and large for gestational age, were comparable between the two groups. However, postpartum glucose intolerance was more prevalent in women with EGDM, particularly in those without obesity who also had significantly lower initial insulin secretion capacity. Insulin resistance was comparable between the groups, suggesting that reduced insulin secretion, rather than insulin resistance, contributes to postpartum glucose intolerance in EGDM.

Conclusions: EGDM in women without obesity is associated with a high risk for postpartum glucose intolerance. This could be related to impaired insulin secretion rather than insulin resistance. These findings highlight the need for close monitoring and tailored interventions for patients with EGDM. More research is required to improve diagnostic and management strategies, considering ethnic variations in insulin secretion and glucose tolerance.

Abstract Image

早发性和晚发性妊娠糖尿病妇女围产期和产后胰岛素分泌能力。
妊娠期糖尿病(GDM)与代谢风险和不良的母体和胎儿围产期结局相关。本研究旨在比较早发性GDM (EGDM)妇女的妊娠结局、产后葡萄糖耐受不良和胰岛素分泌能力。研究设计和方法:这项单中心回顾性研究纳入了107例EGDM妇女和109例LGDM妇女。通过75 g口服葡萄糖耐量试验诊断GDM。产后4-16周评估产后葡萄糖耐量。分析和比较了产妇和新生儿的结局、胰岛素分泌和产后葡萄糖耐量。对有和没有肥胖的妇女进行亚组分析。结果:虽然EGDM妇女的妊娠体重增加明显低于LGDM妇女,但妊娠结局,包括新生儿出生体重,小胎龄和大胎龄,在两组之间具有可比性。然而,产后葡萄糖耐受不良在EGDM患者中更为普遍,尤其是那些没有肥胖且初始胰岛素分泌能力明显较低的女性。胰岛素抵抗在两组之间是相似的,这表明胰岛素分泌减少,而不是胰岛素抵抗,导致了EGDM的产后葡萄糖耐受不良。结论:无肥胖的女性EGDM与产后葡萄糖耐受不良的高风险相关。这可能与胰岛素分泌受损有关,而不是胰岛素抵抗。这些发现强调了对EGDM患者进行密切监测和量身定制干预的必要性。考虑到胰岛素分泌和葡萄糖耐量的种族差异,需要更多的研究来改进诊断和管理策略。
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来源期刊
BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
9.30
自引率
2.40%
发文量
123
审稿时长
18 weeks
期刊介绍: BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.
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