|PUBLIC AND POPULATION HEALTH ARTICLES|
Hidden Metabolic Disturbances in Women with Normal Glucose Tolerance Five Years after Gestational Diabetes
Yvonne Winhofer, Andrea Tura, Anita Thomas, Thomas Prikoszovich, Christine Winzer, Giovanni Pacini, Anton Luger, and Alexandra Kautzky-Willer. International Journal of Endocrinology, Volume 2015, Article ID 342938.
Background. The study aimed to assess whether women with prior gestational diabetes (pGDM), despite maintenance of normal glucose tolerance (NGT) five years after delivery, displaymetabolic disturbances compared to healthy controls.
Methods. 45pGDM with NGT were compared to 18 women without a history of GDM (CON), matched for age (37.0 ± 4.1 versus 35.2 ± 5.3,𝑃 = ns) and BMI (24.3 ± 3.1 versus 23.3 ± 3.3, 𝑃 = ns). Metabolic parameters were derived from oral and intravenous glucose tolerance tests; furthermore lipid profile, C-reactive protein (CRP), adiponectin, leptin, and glucagon were assessed.
Results. Five years postpartum, pGDM had increased glucose concentrations during the OGTT (AUC: 1.12 ± 0.15 versus 1.0 ± 0.12mol/L ∗ min, 𝑃 = 0.003) and insulin sensitivity was decreased compared to CON (OGIS: 467.2 ± 64.1 versus 510.6 ± 53.1 mL/min ∗ m2, 𝑃 = 0.01). pGDM had lower adiponectin (8.1 ± 2.6 versus 12.6 ± 5.3, 𝑃 < 0.008) but increased waist circumference and CRP compared to CON.
Conclusions. Despite diagnosis of normal glucose tolerance, pGDM are characterized by hyperglycemia and insulin resistance compared to healthy controls, accompanied by decreased adiponectin and increased CRP concentrations, thus linking metabolic disturbances to an increased cardiovascular risk in pGDM.
Gestational diabetes: The public health relevance and approach
Seshiah Veeraswamy, Balaji Vijayam, Vitull K. Gupta, Anil Kapura, Dr V. Seshiah
Analysis of Pregnancy Outcomes Using the New IADPSG Recommendation Compared with the Carpenter and Coustan Criteria in an Area with a Low Prevalence of Gestational Diabetes
Katrien Benhalima, Myriam Hanssens, Roland Devlieger, Johan Verhaeghe, and Chantal Mathieu