Visceral Fatness and Insulin Sensitivity in Women With a Previous History of Gestational Diabetes Mellitus

• Published in: Diabetes care Vol. 30; no. 2; pp. 348 - 353
• Main Authors: Lim, Soo, Choi, Sung Hee, Park, Young Joo, Park, Kyong Soo, Lee, Hong Kyu, Jang, Hak C, Cho, Nam H, Metzger, Boyd E
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.02.2007
• Subjects: Adipose Tissue - anatomy & histology; Adult; Biological and medical sciences; Blood Glucose - drug effects; Blood Glucose - metabolism; Body Composition; Body fat; Body Mass Index; Diabetes; Diabetes in pregnancy; Diabetes, Gestational - physiopathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Glucose Intolerance - epidemiology; Glucose Tolerance Test; Glycated Hemoglobin A - analysis; Health aspects; Humans; Insulin; Insulin - blood; Insulin - pharmacology; Korea - epidemiology; Medical sciences; Metabolism; Obesity; Pregnancy; Risk Factors; Viscera - anatomy & histology; Women; Womens history; Asia; Korea; United States; Endocrinopathy; Type 2 diabetes; Visceral fat; Human; Pancreatic hormone; Adipose tissue; Metabolic diseases; Glucose tolerance test; Maternal diseases; Insulin; Pregnancy; Risk factor; Adult; Female; Gestational diabetes; Woman; Public health
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc06-1405

OBJECTIVE:--The purpose of this study was to investigate the insulin sensitivity and visceral fatness in women with previous gestational diabetes mellitus (GDM), who are prone to develop type 2 diabetes. RESEARCH DESIGN AND METHODS--A 75-g oral glucose tolerance test (OGTT) performed 1 year postpartum identified 21 GAD⁻ women with previous GDM and impaired glucose tolerance (GDM-IGT). Sixty age- and BMI-matched women with normal glucose tolerance (GDM-NGT) were selected by 1:3 matching to the GDM-IGT group. Another 18 women with normal glucose metabolism during a previous pregnancy and no family history of diabetes were recruited as the normal control group. Age and BMI matching was performed using a range of ±1.0 years and ±1.0 kg/m², respectively. Total body fat was measured by tetrapolar bioelectrical impedance, and visceral fat was determined using a single cut of a computed tomography scan. Insulin sensitivity was determined by the minimal model technique using the frequently sampled intravenous glucose tolerance test. RESULTS:--One year postpartum, visceral fat was greater in the GDM-IGT group than in the age- and BMI-matched GDM-NGT or normal control groups. The insulin sensitivity index was lower in the GDM-IGT group than in the GDM-NGT or normal control groups. β-Cell function, as measured by the acute insulin response to glucose, was also lower in GDM-IGT. CONCLUSIONS:--High body fat content, especially visceral fat content, and a low insulin response to glucose seem to contribute simultaneously to the development of impaired glucose metabolism in Korean women with previous GDM.