Abnormalities persist postpartum in gravidas with lesser degrees of hyperglycemia

Michael D Berkus, O. Lauger, T. Siler-Khodi

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Recently it lias been shown that gravidas having lesser degrees of hyperglycémie (GDM bv lower threshold criteria of Coustan, Sacks, 1-abnormal GTT value), identify morbidity at an incidence and efficiency comparable to current AGOG standards. 60% of these gravidas also evidence both insulin secretion and sensitivity (S,) below normal during pregnancy. The hypothesis of this study is that these patients would continue to have increased insulin resistance and decreased insulin response postpartum (PP), METHODS: 14 patients with lesser degrees of hvperglvcemia during pregnamv were investigated PP using the insulin-modified, Minimal Model (Bergman) to measure glucose, S,. and 1st phase insulin {0-19 miii). '_>() normal, non-pregnant women matched tor age and obesity were studied as controls. RESULTS: The lesser degree subjects were compared to the ine;m normal curve (see figure). 71% of the sludv women had both S, and insulin response below ihe normal curve, i.e. values in the lower left corner of (he graph. Additionally: (1) 8f)f/c of low responders in pregnancy remained abnormal PP; (2) 20% reverted to normal; (3) All gravidas abo\e the non-GDM curve during pregnancy remained above normal PP. CONCLUSION: The decreased sensitivity and insulin secretion that persists PP in gravidas with lesser degrees of hvperghcemia, form ihe basis of their abnormal glycémie profile and adverse perinatal outcome, and strongly support their being considered at increased risk for future GDM and Type II diabetes.

Original languageEnglish (US)
JournalActa Diabetologica Latina
Volume176
Issue number1 PART II
StatePublished - 1997

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Hyperglycemia
Postpartum Period
Insulin
Insulin Resistance
Pregnancy
Type 2 Diabetes Mellitus
Obesity
Morbidity
Glucose
Incidence

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

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Berkus, M. D., Lauger, O., & Siler-Khodi, T. (1997). Abnormalities persist postpartum in gravidas with lesser degrees of hyperglycemia. Acta Diabetologica Latina, 176(1 PART II).

Abnormalities persist postpartum in gravidas with lesser degrees of hyperglycemia. / Berkus, Michael D; Lauger, O.; Siler-Khodi, T.

In: Acta Diabetologica Latina, Vol. 176, No. 1 PART II, 1997.

Research output: Contribution to journalArticle

Berkus, MD, Lauger, O & Siler-Khodi, T 1997, 'Abnormalities persist postpartum in gravidas with lesser degrees of hyperglycemia', Acta Diabetologica Latina, vol. 176, no. 1 PART II.
Berkus, Michael D ; Lauger, O. ; Siler-Khodi, T. / Abnormalities persist postpartum in gravidas with lesser degrees of hyperglycemia. In: Acta Diabetologica Latina. 1997 ; Vol. 176, No. 1 PART II.
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abstract = "OBJECTIVE: Recently it lias been shown that gravidas having lesser degrees of hyperglyc{\'e}mie (GDM bv lower threshold criteria of Coustan, Sacks, 1-abnormal GTT value), identify morbidity at an incidence and efficiency comparable to current AGOG standards. 60{\%} of these gravidas also evidence both insulin secretion and sensitivity (S,) below normal during pregnancy. The hypothesis of this study is that these patients would continue to have increased insulin resistance and decreased insulin response postpartum (PP), METHODS: 14 patients with lesser degrees of hvperglvcemia during pregnamv were investigated PP using the insulin-modified, Minimal Model (Bergman) to measure glucose, S,. and 1st phase insulin {0-19 miii). '_>() normal, non-pregnant women matched tor age and obesity were studied as controls. RESULTS: The lesser degree subjects were compared to the ine;m normal curve (see figure). 71{\%} of the sludv women had both S, and insulin response below ihe normal curve, i.e. values in the lower left corner of (he graph. Additionally: (1) 8f)f/c of low responders in pregnancy remained abnormal PP; (2) 20{\%} reverted to normal; (3) All gravidas abo\e the non-GDM curve during pregnancy remained above normal PP. CONCLUSION: The decreased sensitivity and insulin secretion that persists PP in gravidas with lesser degrees of hvperghcemia, form ihe basis of their abnormal glyc{\'e}mie profile and adverse perinatal outcome, and strongly support their being considered at increased risk for future GDM and Type II diabetes.",
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