scholarly journals Serum C18:1-Cer as a Potential Biomarker for Early Detection of Gestational Diabetes

2022 ◽  
Vol 11 (2) ◽  
pp. 384
Author(s):  
Ilona Juchnicka ◽  
Mariusz Kuźmicki ◽  
Piotr Zabielski ◽  
Adam Krętowski ◽  
Agnieszka Błachnio-Zabielska ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
High Performance ◽  
First Trimester ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Glucose Levels ◽  
Potential Biomarker

We hypothesized that sphingolipids may be early biomarkers of gestational diabetes mellitus (GDM). Here, 520 women with normal fasting plasma glucose levels were recruited in the first trimester and tested with a 75 g oral glucose tolerance test in the 24th–28th week of pregnancy. Serum sphingolipids concentrations were measured in the first and the second trimester by ultra-high performance liquid chromatography coupled with triple quadrupole mass spectrometry (UHPLC/MS/MS) in 53 patients who were diagnosed with GDM, as well as 82 pregnant women with normal glucose tolerance (NGT) and 32 non-pregnant women. In the first trimester, pregnant women showed higher concentrations of C16:0, C18:1, C22:0, C24:1, and C24:0-Cer and lower levels of sphinganine (SPA) and sphingosine-1-phosphate (S1P) compared to non-pregnant women. During pregnancy, we observed significant changes in C16:0, C18:0, C18:1, and C24:1-Cer levels in the GDM group and C18:1 and C24:0-Cer in NGT. The GDM (pre-conversion) and NGT groups in the first trimester differed solely in the levels of C18:1-Cer (AUC = 0.702 p = 0.008), also considering glycemia. Thus, C18:1-Cer revealed its potential as a GDM biomarker. Sphingolipids are known to be a modulator of insulin resistance, and our results indicate that ceramide measurements in early pregnancy may help with GDM screening.

scholarly journals Real-World Gestational Diabetes Screening: Problems with the Oral Glucose Tolerance Test in Rural and Remote Australia

2019 ◽  
Vol 16 (22) ◽  
pp. 4488 ◽  
Author(s):  
Emma L. Jamieson ◽  
Erica P. Spry ◽  
Andrew B. Kirke ◽  
David N. Atkinson ◽  
Julia V. Marley
Keyword(s):  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Time Course ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Rural And Remote ◽  
Glucose Levels

Gestational diabetes mellitus (GDM) is the most common antenatal complication in Australia. All pregnant women are recommended for screening by 75 g oral glucose tolerance test (OGTT). As part of a study to improve screening, 694 women from 27 regional, rural and remote clinics were recruited from 2015–2018 into the Optimisation of Rural Clinical and Haematological Indicators for Diabetes in pregnancy (ORCHID) study. Most routine OGTT samples were analysed more than four hours post fasting collection (median 5.0 h, range 2.3 to 124 h), potentially reducing glucose levels due to glycolysis. In 2019, to assess pre-analytical plasma glucose (PG) instability over time, we evaluated alternative sample handling protocols in a sample of participants. Four extra samples were collected alongside routine room temperature (RT) fluoride-oxalate samples (FLOXRT): study FLOXRT; ice slurry (FLOXICE); RT fluoride-citrate-EDTA (FC Mix), and RT lithium-heparin plasma separation tubes (PST). Time course glucose measurements were then used to estimate glycolysis from ORCHID participants who completed routine OGTT after 24 weeks gestation (n = 501). Adjusting for glycolysis using FLOXICE measurements estimated 62% under-diagnosis of GDM (FLOXRT 10.8% v FLOXICE 28.5% (95% CI, 20.8–29.5%), p < 0.001). FC Mix tubes provided excellent glucose stability but gave slightly higher results (Fasting PG: +0.20 ± 0.05 mmol/L). While providing a realistic alternative to the impractical FLOXICE protocol, direct substitution of FC Mix tubes in clinical practice may require revision of GDM diagnostic thresholds.

Abstract P337: Association of Glucose Intolerance and Insulin Resistance with Incident Cardiovascular Disease in a Japanese Urban Cohort: The Suita Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Yoshihiro Kokubo ◽  
Makoto Watanabe ◽  
Aya Higashiyama ◽  
Yoko M Nakao ◽  
Takashi Kobayashi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Glucose Tolerance ◽  
Cerebral Infarction ◽  
Glucose Intolerance ◽  
Fasting Glucose ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Glucose Levels

Introduction: Glucose intolerance and insulin resistance are known risk factors for cardiovascular disease (CVD). However, few prospective studies were reported the association between combinations of these two factors and incident CVD. We assessed the hypothesis that insulin resistance increased the association between glucose intolerance and CVD in Japanese general population. Methods: We studied 4,638 Japanese individuals (mean age 56.1 years, without CVD) who completed a baseline medical examination and a 75g oral glucose tolerance test in the Suita Study. Glucose categories were defined as follows: diabetes mellitus (DM; fasting plasma glucose levels [FPG] ≥126 mg/dL, 2 hours post-loaded glucose levels [2h-PG] ≥ 200 mg/dL, and/or DM medication); impaired glucose tolerance (IGT; FPG <126 mg/dL and 2h-PG =140-199 mg/dL); impaired fasting glucose (IFG; FPG =100-125 mg/dL and 2h-PG <140 mg/dL); and normal glucose tolerance [NGT]. Insulin resistance was the following formula: HOMA-IR = [FPG] x [fasting insulin] / 405. Insulin resistance was defined as HOMA-IR ≥2.5. Multivariable-adjusted Cox proportional hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated after adjusting for age, sex, body mass index, blood pressure category, hyperlipidemia, smoking, and drinking at the baseline. Results: During the 11.7-year follow-up, we documented 127 cerebral infarctions, 63 hemorrhagic stroke, 12 unclassified strokes, and 143 coronary heart disease events. The adjusted HRs (95% CIs) of subjects with FPG =100-125 mg/dL and ≥126 mg/dL were 1.38 (1.01-1.89) and 2.00 (1.12-3.58) for stroke and 1.47 (0.99-2.19) and 2.73 (1.43-5.22) for cerebral infarction, respectively, compared with the fasting NGT group. On the basis of the subjects with 2h-PG <140 mg/dL group, the adjusted HRs (95% CIs) of subjects with 2h-PG ≥200 mg/dL were 1.71 (1.07-2.72) for stroke and 2.06 (1.20-3.54) for cerebral infarction. Compared to the NGT group, the adjusted HRs (95% CIs) of the subjects with IFG, IGT, and DM were 1.59 (1.10-2.30), 1.34 (0.89-2.00), and 1.86 (1.16-3.00) for stroke and 1.82 (1.13-2.90), 1.55 (0.93-2.56), and 2.43 (1.39-4.26) for cerebral infarction, respectively. Compared to the subjects with HOMA-IR <1.5, the adjusted HRs (95% CIs) of CVD and stroke with HOMA-IR ≥2.5 were 1.45 (1.07-1.96) and 1.61 (1.07-2.42), respectively. Compared to the NGT group without insulin resistance, the IFG and DM groups with insulin resistance were observed the increased risks of stroke (HRs [95% CIs]; 2.05 [1.17-3.57] and 2.11 [1.17-3.83]) and cerebral infarction (HRs [95% CIs]; 2.45 [1.20-5.00] and 3.56 [1.84-6.88]), respectively. Conclusions: Fasting glucose intolerance and insulin resistance are predictive factors for the incidence of stroke and cerebral infarction. Insulin resistance increased the risks of incident stroke and cerebral infarction in general inhabitants with IFG and DM.

Endocrine pancreatic function in women with gestational diabetes

1986 ◽  
Vol 113 (3_Suppl) ◽  
pp. S19-S23 ◽  
Author(s):  
Claus Kühl ◽  
Peter J. Hornnes
Keyword(s):  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Pregnant Women ◽  
Insulin Response ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Insulin Degradation ◽  
Insulinogenic Index ◽  
Insulin Responses ◽  
In Pregnancy

Abstract. Glucose tolerance deteriorates in normal human pregnancy but 99% of all pregnant women retain normal glucose tolerance whereas the remaining 1% develop abnormal glucose tolerance and are designated gestational diabetics. The possibility that glucose tolerance deteriorates in pregnancy because of diabetes-like changes in the secretory function of the endocrine pancreas has been investigated in gestational diabetics and healthy controls. Even though the insulin responses to oral glucose and mixed meals are equally large in gestational diabetics and normal pregnant women, the insulin responses of the gestational diabetics differ in two pertinent ways from those of the normals. First, a delayed insulin response is frequently seen, and second, the insulin response per unit of glycaemic stimulus (the 'insulinogenic index') is normally significantly lower than that of the normal pregnant women. Diabetes-like changes in the secretion of glucagon are not seen in neither group. Insulin degradation is unaffected by pregnancy and the proinsulin share of the total plasma insulin immunoreactivity does not increase in pregnancy. It is therefore likely that the main reason for the diabetogenicity of pregnancy is insulin resistance. Most pregnant women are able to increase their insulin secretion and thus overcome the resistance. Some pregnant women do, however, seem to have a more limited insulin secretory capacity which eventually may lead to the development of gestational diabetes.

Effects of metformin and insulin therapy regimens on postpartum oral glucose tolerance test results in pregnant women with gestational diabetes mellitus: a comparative study

2020 ◽  
Vol 41 (4) ◽  
Author(s):  
Moghadaseh Jahanshahi ◽  
Arash Rezaei Shahmirzadi ◽  
Elham Kashani ◽  
Reza Alipoor ◽  
Shoreh Vosough
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Insulin Therapy ◽  
Pregnant Women ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Maternal Weight

AbstractObjectivesThe main purpose of this study was to compare the effects of two regimens of metformin and insulin therapy on postpartum oral glucose tolerance test (OGTT) results in pregnant women with gestational diabetes mellitus (GDM).MethodsIn this single-blind randomized clinical trial (RCT), a total number of 60 pregnant women meeting the inclusion criteria were assigned to two groups with a randomized block design (RBD): insulin therapy (IT) group (30 patients) and metformin therapy (MT) group (30 patients). At baseline, the data were comprised of prenatal maternal age, gestational age, GDM diagnosis, and maternal weight/height. During the postpartum period, 5-cc blood samples were taken from the pregnant women concerned to analyze their fasting blood sugar (FBS) levels. Then, the patients were asked to come back four days and six weeks later after delivery to check the OGTT results. At six weeks postpartum, in addition to OGTT, the glycated hemoglobin (HbA1C) test was performed for all mothers. Finally, six weeks after delivery, these mothers were evaluated with regard to weight loss and body mass index (BMI).ResultsSix weeks postpartum, the maternal weight and BMI significantly decreased in the MT group compared with the IT one, while there was no significant difference between both groups at baseline. On the fourth day, the OGTT results in the MT group were significantly lower in comparison with those in the IT group (p=0.012). At sixth weeks postpartum, the OGTT results were comparably lower in the MT group than those reported for the IT one; however, such a difference was not statistically significant (p=0.087).ConclusionsAccording to the study results, metformin could be an effective and safe treatment for pregnant women suffering from GDM instead of insulin therapy.

scholarly journals Reduced Lung Function and Progression to Prediabetes: A Prospective Study

2021 ◽  
Author(s):  
Ovais Karnain Wadoo ◽  
Ishtiaq Ahmad ◽  
Sheikh Imran Sayeed
Keyword(s):  
Lung Function ◽  
Glucose Tolerance ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Forced Expiratory Volume ◽  
P Value ◽  
Oral Glucose ◽  
Glucose Levels ◽  
Lung Dysfunction

Objective: Prediabetes is a state that people have blood glucose levels higher than normal but still not in diabetes range. There is a close relationship between impaired lung function and diabetes mellitus (DM). Reduced lung function can be present before the clinical evidence of diabetes or insulin resistance. Materials and Methods: The total number of subjects in this longitudinal study was 503 and compared with apparently healthy Kashmiri adults. All the subjects, at the time of their first visit, underwent Fasting Plasma Glucose (FPG) estimation, 2- hour oral glucose tolerance test (OGTT) and spirometry (FVC, FEV1 & FEV1/FVC). Those subjects who had normal glucose tolerance (NGT) were retested for glycemic status and spirometric values after a follow-up period of 2-18 (mean=10) months. Results: Out of total 503 subjects on follow up 483 (96%) had NGT and 20 (4%) had prediabetes. Percent predicted forced vital capacity (FVC) and % predicted forced expiratory volume in 1st second (FEV1) were significantly lower (P-value< 0.001) while as % predicted FEV1/FVC was significantly higher (P-value< 0.001) in prediabetes as compared to NGT group. Conclusion: Results of our study point out a predominantly restrictive pattern of lung dysfunction in the prediabetes group as compared to the NGT group.

Glucose tolerance in singleton, twin and triplet pregnancies

2016 ◽  
Vol 44 (8) ◽  
Author(s):  
Amir Weissman ◽  
Arie Drugan
Keyword(s):  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Challenge Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Glucose Levels ◽  
Glucose Challenge Test ◽  
Glucose Challenge ◽  
Mean Glucose ◽  
Twin Pregnancies

AbstractBackground:Data regarding the effects of multifetal pregnancy on the incidence of gestational diabetes mellitus (GDM) are inconsistent and even conflicting. Twin pregnancies have been associated with no increase, a marginal increase or a higher incidence of gestational diabetes. In triplet pregnancies, these effects have not been investigated yet.Objectives:To analyze the results of the glucose challenge and tolerance tests in singleton, twin and triplet pregnancies.Study design:A retrospective database analysis of pregnant women with singletons, twins or triplets who had complete results of the 50 g glucose challenge test (GCT) and the 100 g oral glucose tolerance test (OGTT). The cohort included 12,382 singletons, 515 twins and 39 triplets.Results:There were significantly higher rates of abnormal GCTs in twins and triplets compared to singletons (45.4% and 33.3%, respectively vs. 13.7%, P<0.001 and P<0.05). Significantly higher rates of gestational diabetes in twins (10.1% vs. 2.9 %, P<0.001) and triplets (12.8% vs. 2.9%, P<0.05) compared to singletons were observed. Mean glucose levels after the GCT were higher in twins compared to singletons, and even more in triplets (108 mg/dL in singletons vs. 120 mg/dL in twins vs. 129 mg/dL in triplets, P<0.001).Conclusions:Glucose intolerance is aggravated in multifetal pregnancies. The likelihood of an abnormal GCT and gestational diabetes is higher in twins and triplets compared to singletons.

Impaired β-cell compensation to dexamethasone-induced hyperglycemia in women with polycystic ovary syndrome

2004 ◽  
Vol 287 (2) ◽  
pp. E241-E246 ◽  
Author(s):  
David A. Ehrmann ◽  
Elena Breda ◽  
Matthew C. Corcoran ◽  
Melissa K. Cavaghan ◽  
Jacqueline Imperial ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Polycystic Ovary ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Oral Glucose ◽  
Β Cell ◽  
Glucose Levels ◽  
Control Subjects ◽  
And Control

Deterioration in glucose tolerance occurs rapidly in women with polycystic ovary syndrone (PCOS), suggesting that pancreatic β-cell dysfunction may supervene early. To determine whether the compensatory insulin secretory response to an increase in insulin resistance induced by the glucocorticoid dexamethasone differs in women with PCOS and control subjects, we studied 10 PCOS and 6 control subjects with normal glucose tolerance. An oral glucose tolerance test (OGTT) and a graded glucose infusion protocol were performed at baseline and after subjects took 2.0 mg of dexamethasone orally. Basal (Φb), static (Φs), dynamic (Φd), and global (Φ) indexes of β-cell sensitivity to glucose were derived. Insulin sensitivity (Si) was calculated using the minimal model; a disposition index (DI) was calculated as the product of Si and Φ. PCOS and control subjects had nearly identical fasting and 2-h glucose levels at baseline. Φb was higher, although not significantly so, in the PCOS subjects. The Φd, Φs, and Φ indexes were 28, 19, and 20% higher, respectively, in PCOS subjects. The DI was significantly lower in PCOS (30.01 ± 5.33 vs. 59.24 ± 7.59) at baseline. After dexamethasone, control subjects averaged a 9% increase (to 131 ± 12 mg/dl) in 2-h glucose levels; women with PCOS had a significantly greater 26% increase to 155 ± 6 mg/dl. The C-peptide-to-glucose ratios on OGTT increased by 44% in control subjects and by only 15% in PCOS subjects. The accelerated deterioration in glucose tolerance in PCOS may result, in part, from a relative attenuation in the response of the β-cell to the demand placed on it by factors exacerbating insulin resistance.

scholarly journals No difference in exogenous carbohydrate oxidation during exercise in children with and without impaired glucose tolerance

2016 ◽  
Vol 121 (3) ◽  
pp. 724-729 ◽  
Author(s):  
Lisa Chu ◽  
Katherine M. Morrison ◽  
Michael C. Riddell ◽  
Sandeep Raha ◽  
Brian W. Timmons
Keyword(s):  
Insulin Sensitivity ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Whole Body ◽  
Oral Glucose ◽  
Insulin Resistant ◽  
Glucose Levels

The capacity to match carbohydrate (CHO) utilization with availability is impaired in insulin-resistant, obese adults at rest. Understanding exogenous carbohydrate (CHOexo) oxidation during exercise and its association to insulin resistance (IR) is important, especially in children at risk for type 2 diabetes. Our objective was to examine the oxidative efficiency of CHOexo during exercise in obese children with normal glucose tolerance (NGT) or impaired glucose tolerance (IGT). Children attended two visits and were identified as NGT ( n = 22) or IGT ( n = 12) based on 2-h oral glucose tolerance test (OGTT) glucose levels of <7.8 mmol/l or ≥7.8 mmol/l, respectively. Anthropometry, body composition, and aerobic fitness (V̇o2max) were assessed. Insulin and glucose at baseline, 30, 60, 90, and 120 min during the OGTT were used to calculate measures of insulin sensitivity. On a separate day, a 13C-enriched CHO drink was ingested before exercise (3 × 20 min bouts) at 45% V̇o2max. Breath measurements were collected to calculate CHOexo oxidative efficiency. CHOexo oxidative efficiency during exercise was similar in IGT (17.0 ± 3.6%) compared with NGT (17.1 ± 4.4%) ( P = 0.90) despite lower whole body insulin sensitivity in IGT at rest ( P = 0.02). Area under the curve for insulin (AUCins) measured at rest during the OGTT was greater in IGT compared with NGT ( P = 0.04). The ability of skeletal muscle to utilize CHOexo was not impaired during exercise in children with IGT.

scholarly journals Comparing the first trimester and second trimester fifty grams oral glucose tolerance test values in gestational diabetes mellitus

2021 ◽  
pp. 1-9
Author(s):  
Hasan Turan
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Early Period ◽  
First Trimester ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Second Trimester ◽  
Glucose Levels ◽  
History Of

Objective: The present study aimed to assess the results of pregnant women who have been applied a 50 g oral glucose tolerance test (OGTT) in the first and second trimesters and investigate this method’s role in the diagnosis of gestational diabetes mellitus (GDM) and risk factors associated with this disease. Material and Methods: This retrospective study was performed on 153 pregnant women who were admitted to our hospital’s antenatal clinics between March 2011 and August 2011. Fifty grams OGTT was applied to the same pregnant women both in the 1st trimester (between 8th and 14th weeks) and second trimester (between 24th and 28th weeks); values of the test results were then compared. A 100 g OGTT di- agnostic test was performed on those with a 50 g OGTT value of ≥140 mg/dl in both trimesters. The study patients were divided into two groups as non-GDM and GDM based on venous plasma glucose values measured 1 h after 50 g of oral glucose load given. The non-GDM group consisted of those with plasma glucose levels <140 mg/ dl and plasma glucose levels between 140 mg/dl and 200mg/dl, GDM group plasma glucose levels ≥200 mg/dl. First trimester and second-trimester OGTT values and possible risk factors for GDM (age, gravida, parity, number of abortions, smoking, a previous GDM history, etc.) were compared between non-GDM and GDM groups. Results: GDM, diagnosed in 4.5% (7) in the first trimester (between 8th and 14th weeks) and 6.5% (10) second trimester, was detected in 11% (17) of 153 pregnant women in the present study. GDM, diagnosed in 41.2% (7 patients) in the first trimester and 58.8% (10 patients) second trimester, was found with a higher rate in pregnant women over 30 years (p=0.000 <0.05). The mean fasting blood glucose (FBG) level was 96 mg/dl in the GDM group and 83 mg/dl in the non-GDM group, with a statistically sig- nificant difference, which existed (p<0.05). The mean 50 g OGTT value was 170 mg/ dl in pregnant women diagnosed with GDM in the first trimester, and it was 140 mg/dl in those diagnosed in the second trimester, with this difference was considered statis- tically different (p<0.05). Age, parity, a family history of DM, FBG, a previous GDM his- tory, gravida, a previous macrosomia history, and a previous history of preeclampsia were determined as risk factors that significantly increase the risk of GDM (p<0.05). The half of patients was diagnosed with GDM in the early period of pregnancy. In the present study, 41.2% of cases were diagnosed in the first trimester and 58.8% in the second trimester. In general, the patients diagnosed in the first trimester were those being under risk in terms of GDM. According to the present study, it is recommended that the pregnant women should be scanned for GDM in the early period. Conclusion: With screening tests to be applied to risky groups in early pregnancy, a significant number of cases with GDM recently be detected on time. Thereby, mater- nal and fetal morbidity and mortality rates might be considerably reduced thanks to providing proper treatments and regular monitoring. Furthermore, for obtaining spe- cific data concerning the factors with potential influence on the risk of GDM, further studies on this topic need to be performed.

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