Women with prior gestational diabetes mellitus and prediabetes are characterised by a decreased incretin effect
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Women with prior gestational diabetes mellitus and prediabetes are characterised by a decreased incretin effect. / Foghsgaard, Signe; Vedtofte, Louise; Andreasen, Camilla; Andersen, Emilie S; Bahne, Emilie; Bagger, Jonatan I; Svare, Jens A; Holst, Jens J; Clausen, Tine D; Mathiesen, Elisabeth R; Damm, Peter; Knop, Filip K; Vilsbøll, Tina.
I: Diabetologia, Bind 60, Nr. 7, 07.2017, s. 1344-1353.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Women with prior gestational diabetes mellitus and prediabetes are characterised by a decreased incretin effect
AU - Foghsgaard, Signe
AU - Vedtofte, Louise
AU - Andreasen, Camilla
AU - Andersen, Emilie S
AU - Bahne, Emilie
AU - Bagger, Jonatan I
AU - Svare, Jens A
AU - Holst, Jens J
AU - Clausen, Tine D
AU - Mathiesen, Elisabeth R
AU - Damm, Peter
AU - Knop, Filip K
AU - Vilsbøll, Tina
PY - 2017/7
Y1 - 2017/7
N2 - AIMS/HYPOTHESIS: We investigated whether a reduced incretin effect, as observed in patients with type 2 diabetes, can be detected in high-risk individuals, such as women with prior gestational diabetes mellitus (pGDM).METHODS: In this cross-sectional study, 102 women without diabetes with pGDM and 15 control participants without pGDM and with normal glucose tolerance (NGT) underwent a 4 h 75 g OGTT and an isoglycaemic i.v. glucose infusion (IIGI). Women with pGDM were classified as having NGT or prediabetes (impaired fasting glucose and/or impaired glucose tolerance). Insulin sensitivity was assessed using the Matsuda index and HOMA2-IR and the incretin effect was calculated from insulin responses during the study (100% × [AUCinsulin,OGTT - AUCinsulin,IIGI]/AUCinsulin,OGTT).RESULTS: Sixty-three of the 102 women with pGDM (62%) had prediabetes (median [interquartile range]: age, 38.3 [6.5] years; BMI, 32.1 [5.8] kg/m(2)) and 39 women (38%) had NGT (age, 39.5 [5.6] years; BMI, 31.0 [6.7] kg/m(2)). Control participants (n = 15) were not significantly different from the pGDM group with regards to age (39.2 [7.4] years) and BMI (28.8 [9.2] kg/m(2)). Compared with women with NGT and control participants, women with prediabetes had lower insulin sensitivity, as measured by the Matsuda index (3.0 [2.4] vs 5.0 [2.6] vs 1.5 [1.8], respectively; p < 0.001). The incretin effect was 55.3% [27.8], 73.8% [19.0] and 76.7% [24.6] in women with prediabetes, women with normal glucose tolerance and control participants, respectively (p < 0.01).CONCLUSION/INTERPRETATION: Prediabetes was highly prevalent in women with pGDM, and alterations in the incretin effect were detected in this group before the development of type 2 diabetes.TRIAL REGISTRATION: clinicaltrialsregister.eu 2012-001371-37-DK.
AB - AIMS/HYPOTHESIS: We investigated whether a reduced incretin effect, as observed in patients with type 2 diabetes, can be detected in high-risk individuals, such as women with prior gestational diabetes mellitus (pGDM).METHODS: In this cross-sectional study, 102 women without diabetes with pGDM and 15 control participants without pGDM and with normal glucose tolerance (NGT) underwent a 4 h 75 g OGTT and an isoglycaemic i.v. glucose infusion (IIGI). Women with pGDM were classified as having NGT or prediabetes (impaired fasting glucose and/or impaired glucose tolerance). Insulin sensitivity was assessed using the Matsuda index and HOMA2-IR and the incretin effect was calculated from insulin responses during the study (100% × [AUCinsulin,OGTT - AUCinsulin,IIGI]/AUCinsulin,OGTT).RESULTS: Sixty-three of the 102 women with pGDM (62%) had prediabetes (median [interquartile range]: age, 38.3 [6.5] years; BMI, 32.1 [5.8] kg/m(2)) and 39 women (38%) had NGT (age, 39.5 [5.6] years; BMI, 31.0 [6.7] kg/m(2)). Control participants (n = 15) were not significantly different from the pGDM group with regards to age (39.2 [7.4] years) and BMI (28.8 [9.2] kg/m(2)). Compared with women with NGT and control participants, women with prediabetes had lower insulin sensitivity, as measured by the Matsuda index (3.0 [2.4] vs 5.0 [2.6] vs 1.5 [1.8], respectively; p < 0.001). The incretin effect was 55.3% [27.8], 73.8% [19.0] and 76.7% [24.6] in women with prediabetes, women with normal glucose tolerance and control participants, respectively (p < 0.01).CONCLUSION/INTERPRETATION: Prediabetes was highly prevalent in women with pGDM, and alterations in the incretin effect were detected in this group before the development of type 2 diabetes.TRIAL REGISTRATION: clinicaltrialsregister.eu 2012-001371-37-DK.
KW - Journal Article
U2 - 10.1007/s00125-017-4265-8
DO - 10.1007/s00125-017-4265-8
M3 - Journal article
C2 - 28364253
VL - 60
SP - 1344
EP - 1353
JO - Diabetologia
JF - Diabetologia
SN - 0012-186X
IS - 7
ER -
ID: 183006849