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Glucose Absorption in Gestational Diabetes Mellitus During an Oral Glucose Tolerance Test

OBJECTIVE: Women with gestational diabetes mellitus (GDM) show reduced insulin sensitivity and markedly elevated glucose excursions. After delivery, GDM mostly reverts to normal glucose tolerance (NGT), although leaving an increased risk of type 2 diabetes. Because gastrointestinal function changes...

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Autores principales: Anderwald, Christian, Tura, Andrea, Winhofer, Yvonne, Krebs, Michael, Winzer, Christine, Bischof, Martin G., Luger, Anton, Pacini, Giovanni, Kautzky-Willer, Alexandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120199/
https://www.ncbi.nlm.nih.gov/pubmed/21602425
http://dx.doi.org/10.2337/dc10-2266
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author Anderwald, Christian
Tura, Andrea
Winhofer, Yvonne
Krebs, Michael
Winzer, Christine
Bischof, Martin G.
Luger, Anton
Pacini, Giovanni
Kautzky-Willer, Alexandra
author_facet Anderwald, Christian
Tura, Andrea
Winhofer, Yvonne
Krebs, Michael
Winzer, Christine
Bischof, Martin G.
Luger, Anton
Pacini, Giovanni
Kautzky-Willer, Alexandra
author_sort Anderwald, Christian
collection PubMed
description OBJECTIVE: Women with gestational diabetes mellitus (GDM) show reduced insulin sensitivity and markedly elevated glucose excursions. After delivery, GDM mostly reverts to normal glucose tolerance (NGT), although leaving an increased risk of type 2 diabetes. Because gastrointestinal function changes during pregnancy causing vomiting, constipation, or reduced motility, we thought that gut glucose absorption in GDM or pregnancy might be altered to affect circulating glucose excursions. RESEARCH DESIGN AND METHODS: By undergoing 180-min oral glucose tolerance tests (OGTTs), pregnant women with GDM (GDM(preg); n = 15, BMI = 32 ± 2 kg/m(2), aged 33 ± 1 years) were compared with NGT women (NGT(preg); n = 7, BMI = 28 ± 1 kg/m(2), aged 34 ± 2 years), matching for major anthropometric characteristics (each P > 0.2). After delivery (6–7 months later), both groups were studied the same way. We computed and mathematically modeled gut glucose absorption from insulin-mediated glucose disappearance and endogenous glucose production (EGP). Whole-body insulin sensitivity was calculated using the Clamp-like Index. RESULTS: GDM(preg) showed 16–25% higher plasma glucose concentrations (P < 0.04) during the final 2 h of OGTT, similar EGP, but lower (P < 0.01) insulin sensitivity (2.7 ± 0.2 mg · kg(−1) · min(−1) vs. NGT(preg): 4.5 ± 0.8 mg · kg(−1) · min(−1)). In GDM(preg), gut glucose absorption rates were ≤52% lower from 30 to 120 min (P < 0.03 vs. conditions after delivery or NGT(preg)). In contrast, glucose absorption rates in NGT(preg) were comparable during and after pregnancy. None of the studied women developed diabetes after delivery. CONCLUSIONS: In GDM(preg), OGTT gut glucose absorption is markedly lower during hyperglycemia, whereas both glycemia and glucose absorption in NGT(preg) are comparable between pregnant and postpartum states. Thus, hyperglycemia in GDM does not seem to result from too rapid or increased glucose absorption.
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spelling pubmed-31201992012-07-01 Glucose Absorption in Gestational Diabetes Mellitus During an Oral Glucose Tolerance Test Anderwald, Christian Tura, Andrea Winhofer, Yvonne Krebs, Michael Winzer, Christine Bischof, Martin G. Luger, Anton Pacini, Giovanni Kautzky-Willer, Alexandra Diabetes Care Original Research OBJECTIVE: Women with gestational diabetes mellitus (GDM) show reduced insulin sensitivity and markedly elevated glucose excursions. After delivery, GDM mostly reverts to normal glucose tolerance (NGT), although leaving an increased risk of type 2 diabetes. Because gastrointestinal function changes during pregnancy causing vomiting, constipation, or reduced motility, we thought that gut glucose absorption in GDM or pregnancy might be altered to affect circulating glucose excursions. RESEARCH DESIGN AND METHODS: By undergoing 180-min oral glucose tolerance tests (OGTTs), pregnant women with GDM (GDM(preg); n = 15, BMI = 32 ± 2 kg/m(2), aged 33 ± 1 years) were compared with NGT women (NGT(preg); n = 7, BMI = 28 ± 1 kg/m(2), aged 34 ± 2 years), matching for major anthropometric characteristics (each P > 0.2). After delivery (6–7 months later), both groups were studied the same way. We computed and mathematically modeled gut glucose absorption from insulin-mediated glucose disappearance and endogenous glucose production (EGP). Whole-body insulin sensitivity was calculated using the Clamp-like Index. RESULTS: GDM(preg) showed 16–25% higher plasma glucose concentrations (P < 0.04) during the final 2 h of OGTT, similar EGP, but lower (P < 0.01) insulin sensitivity (2.7 ± 0.2 mg · kg(−1) · min(−1) vs. NGT(preg): 4.5 ± 0.8 mg · kg(−1) · min(−1)). In GDM(preg), gut glucose absorption rates were ≤52% lower from 30 to 120 min (P < 0.03 vs. conditions after delivery or NGT(preg)). In contrast, glucose absorption rates in NGT(preg) were comparable during and after pregnancy. None of the studied women developed diabetes after delivery. CONCLUSIONS: In GDM(preg), OGTT gut glucose absorption is markedly lower during hyperglycemia, whereas both glycemia and glucose absorption in NGT(preg) are comparable between pregnant and postpartum states. Thus, hyperglycemia in GDM does not seem to result from too rapid or increased glucose absorption. American Diabetes Association 2011-07 2011-06-17 /pmc/articles/PMC3120199/ /pubmed/21602425 http://dx.doi.org/10.2337/dc10-2266 Text en © 2011 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Anderwald, Christian
Tura, Andrea
Winhofer, Yvonne
Krebs, Michael
Winzer, Christine
Bischof, Martin G.
Luger, Anton
Pacini, Giovanni
Kautzky-Willer, Alexandra
Glucose Absorption in Gestational Diabetes Mellitus During an Oral Glucose Tolerance Test
title Glucose Absorption in Gestational Diabetes Mellitus During an Oral Glucose Tolerance Test
title_full Glucose Absorption in Gestational Diabetes Mellitus During an Oral Glucose Tolerance Test
title_fullStr Glucose Absorption in Gestational Diabetes Mellitus During an Oral Glucose Tolerance Test
title_full_unstemmed Glucose Absorption in Gestational Diabetes Mellitus During an Oral Glucose Tolerance Test
title_short Glucose Absorption in Gestational Diabetes Mellitus During an Oral Glucose Tolerance Test
title_sort glucose absorption in gestational diabetes mellitus during an oral glucose tolerance test
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120199/
https://www.ncbi.nlm.nih.gov/pubmed/21602425
http://dx.doi.org/10.2337/dc10-2266
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