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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Diabetes Association
2011
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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. |
format | Online Article Text |
id | pubmed-3120199 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
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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