1435-P: Impaired Early-Phase Suppression of Glucagon Secretion after Glucose Load Associated with Insulin Need during Pregnancy in Gestational Diabetes

Abstract Background: Gestational diabetes mellitus (GDM) is common and can have a substantial impact on fetal growth, birth weight, and morbidity. The American Diabetes Association recommends GDM testing with either a 3-h, 100-g glucose load (100g) (criteria according to Am J Obstet Gynecol 1982;144:768–73) or a 2-h, 75-g glucose load (75g). We investigated the comparability of the 75g and the 100g tests in the diagnosis of GDM. Methods: From January 1997 to December 1999, in 1061 consecutive Caucasian nonobese and nondiabetic pregnant women who attended the Maternal-Fetal Medicine Unit, we performed GDM testing with a 75-g load during 2 periods of pregnancy: early (16–20 weeks) and late (26–30 weeks). Because we assumed there would be few GBM cases in women with a 1-h plasma glucose <1300 mg/L in the 75g test, we did not retest these women. We retested the remaining women with possible or diagnosed GDM with a 100-g load within a week. Results: GDM was diagnosed in 41 of 227 women with the 100-g load and 15 of 227 with the 75-g load (11 concordant); the κ index was 0.21. At 26–31 weeks of pregnancy, 484 of 976 women (49.9%) underwent both tests. GDM was diagnosed in 60 of 484 woman with the 100-g load and in 26 of 484 with the 75-g load (13 concordant); the κ index was 0.18. Conclusions: Among women with possible GDM in both early and late periods of pregnancy, there was only weak diagnostic agreement between results determined with 75-g and 100-g glucose loads.

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Maternal Metabolites Associated with Gestational Diabetes Mellitus and a Postpartum Disorder of Glucose Metabolism

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab513 ◽

2021 ◽

Author(s):

Yu Liu ◽

Alan Kuang ◽

James R Bain ◽

Michael J Muehlbauer ◽

Olga R Ilkayeva ◽

...

Keyword(s):

Diabetes Mellitus ◽

Glucose Metabolism ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Adverse Pregnancy Outcome ◽

Model Assessment ◽

Glucose Load ◽

Serum Samples ◽

Metabolic Traits ◽

Postpartum Disorders

Abstract Objective To identify circulating metabolites present at ~28 weeks’ gestation associated with gestational diabetes mellitus (GDM) and development of a disorder of glucose metabolism 10-14 years later. Methods Conventional clinical and targeted metabolomics analyses were performed on fasting and 1-hr serum samples following a 75g glucose load at ∼28 weeks’ gestation from 2,290 women who participated in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. Postpartum metabolic traits included fasting and 2-hr plasma glucose following a 75g glucose load, insulin resistance estimated by homeostasis model assessment, and disorders of glucose metabolism (prediabetes and type 2 diabetes) during the HAPO Follow-Up Study. Results Per-metabolite analyses identified numerous metabolites, ranging from amino acids and carbohydrates to fatty acids and lipids, before and 1-hr after a glucose load that were associated with GDM as well as development of a disorder of glucose metabolism and metabolic traits 10-14 years postpartum. A core group of fasting and 1-hr metabolites mediated, in part, the relationship between GDM and postpartum disorders of glucose metabolism, with the fasting and 1-hr metabolites accounting for 15.7% (7.1%-30.8%) and 35.4% (14.3%-101.0%) of the total effect size, respectively. For prediction of a postpartum disorder of glucose metabolism, addition of circulating fasting or 1-hr metabolites at ~28 weeks’ gestation showed little improvement in prediction performance compared to clinical factors alone. Conclusions The results demonstrate association of multiple metabolites with GDM and postpartum metabolic traits and begin to define the underlying pathophysiology of the transition from GDM to a postpartum disorder of glucose metabolism.

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Impaired early phase insulin secretion associated with gestational diabetes mellitus in underweight women

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2020.1779692 ◽

2020 ◽

pp. 1-3

Author(s):

Yoshifumi Kasuga ◽

Kei Miyakoshi ◽

Yoshifumi Saisho ◽

Satoru Ikenoue ◽

Daigo Ochiai ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Secretion ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Early Phase

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Predictive Value of 1 Hour 50g Oral Glucose Load Screening Test for Gestational Diabetes Mellitus Compared to 3 Hour Oral Glucose Tolerance Test in High Risk Pregnant Women

Asia-Oceania Journal of Obstetrics and Gynaecology ◽

10.1111/j.1447-0756.1993.tb00340.x ◽

2010 ◽

Vol 19 (1) ◽

pp. 7-12 ◽

Cited By ~ 3

Author(s):

Mayuree Jirapinyo ◽

Gobchai Puavilai ◽

Suwannee Chanprasertyotin ◽

Somsak Tangtrakul

Keyword(s):

Diabetes Mellitus ◽

High Risk ◽

Gestational Diabetes ◽

Glucose Tolerance ◽

Glucose Tolerance Test ◽

Tolerance Test ◽

Oral Glucose ◽

Oral Glucose Tolerance ◽

Oral Glucose Load ◽

Glucose Load

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Regulation of glucagon secretion by incretin-like hormone family in the patients at risk of developing type 2 diabetes mellitus

Problems of Endocrinology ◽

10.14341/probl201460132-35 ◽

2014 ◽

Vol 60 (1) ◽

pp. 32-35

Author(s):

E A Shestakova ◽

A V Ilyin ◽

A D Deev ◽

M V Shestakova ◽

I I Dedov

Keyword(s):

Type 2 Diabetes ◽

High Risk ◽

Glucose Tolerance ◽

Glucagon Secretion ◽

Tolerance Test ◽

Normal Glucose Tolerance ◽

High Risk Group ◽

Oral Glucose ◽

Glucose Load

The study included 127 patients with type 2 diabetes (T2D) risk factors, who underwent oral glucose tolerance test (75 g glucose) with pancreatic and incretin hormones estimated in fasting state, at 30 and 120 minutes after glucose load. According to the test results the population was divided into 3 groups: group with normal glucose tolerance (NGT), group with high risk of diabetes developing (impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG)) and newly-diagnosed T2D. The stimulated glucagon secretion was suppressed in NGT group, whereas in T2D patients there was an increase in glucagon levels at 30 min after the glucose load. Within high risk group the area under curve (AUC) of glucagon secretion was significantly elevated in IFG patients comparing to IGT (0,52 vs 0,07 ng·ml-1·min-1, р=0,0005). AUC of glucagon secretion was positively related only to fasting glucagon-like peptide 2 (GLP-2) level (r=0,61, р=0,0001), that suggests glucagonotropic properties for GLP-2. We conclude that glucagon stimulation by GLP-2 may play a role in decreased glucagon suppression in T2D patients and IFG state development.

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DISPARITY IN DIAGNOSIS OF GESTATIONAL DIABETES MELLITUS USING 75g AND 100g GLUCOSE LOAD TESTS AMONG ANTE-NATAL ATTENDEES AT MADONNA UNIVERSITY TEACHING HOSPITAL, ELELE, RIVERS STATE

IOSR Journal of Pharmacy (IOSRPHR) ◽

10.9790/3013-0309-01-06 ◽

2013 ◽

Vol 03 (09) ◽

pp. 01-06

Author(s):

C.G.ORLUWENE C.G.ORLUWENE

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Teaching Hospital ◽

University Teaching ◽

Glucose Load ◽

Load Tests ◽

Rivers State

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Gestational diabetes mellitus - need for universal screening - a clinical study in a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211522 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1973

Author(s):

Kondapuram Veena ◽

Srilakshmi Ambarkar ◽

Srilakshmi Ambarkar

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Gestational Age ◽

Universal Screening ◽

Tertiary Care ◽

Antenatal Visit ◽

Oral Glucose ◽

Glucose Load

Background: To study the prevalence of gestational diabetes mellitus among antenatal mothers and to assess the importance of universal screening to detect gestational diabetes mellitus (GDM).Methods: A total of 300 antenatal women irrespective of gestational age were screened for GDM at their antenatal visit during the period of January 2020 to June 2020. All women were screened with 75gm oral glucose load irrespective of last meal followed by blood glucose estimation by glucose oxidase peroxidase method 2 hours following glucose load. A cut-off of 140mg/dl or more were labelled as gestational diabetes mellitus as per DIPSI guidelines.Results: Out of 300 antenatal women tested, 24 women (8%) were positive for gestational diabetes mellitus. During the first, second and third trimesters 12.5%, 33.33% and 54.17% were diagnosed with gestational diabetes mellitus respectively. The number of gestational diabetes mellitus patients for the age groups ≤20 years, 21-25 years, 26-30 years and >30 years are 2 (8.33%), 3 (12.5%), 8 (33.33%) and 11 (45.83%) respectively. The number of pregnant women tested positive for gestational diabetes mellitus with BMI ≤18.5, 18.6-24.9, 25-29.9 and 30-35 are 2 (8.33%), 4(16.67%), 8(33.33%) and 10(41.67%) respectively.Conclusions: Prevalence of GDM in our study is 8%. About 29.16% of GDM did not have any risk factors. This emphasizes the importance of universal screening for GDM of all pregnant women irrespective of gestational age. There is an increased association of GDM with age, BMI, family history and parity according to our study.

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