1. Early metabolic defects following gestational diabetes in three ethnic groups of anti-GAD antibodies negative women with normal fasting glucose.
- Author
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Kousta E, Lawrence NJ, Godsland IF, Penny A, Anyaoku V, Millauer BA, Robinson S, Johnston DG, and McCarthy MI
- Subjects
- Adult, Asian People, Black People, Blood Glucose metabolism, Caribbean Region ethnology, Fasting blood, Female, Glucose Tolerance Test, Homeostasis, Humans, Insulin blood, Insulin Resistance, Metabolic Diseases ethnology, Metabolic Diseases physiopathology, Pregnancy, White People, Antibodies blood, Diabetes Complications, Diabetes, Gestational ethnology, Diabetes, Gestational immunology, Glutamate Decarboxylase immunology, Metabolic Diseases etiology
- Abstract
Objective: To characterise early metabolic abnormalities and the impact of ethnicity following gestational diabetes mellitus (GDM)., Design: Women with a history of GDM belonging to three different ethnic groups were evaluated. Using the insulin-modified, frequently-sampled intravenous glucose tolerance test (FSIVGTT) and HOMA we studied 34 European, 16 South Asian and 10 Afro-Caribbean women with normal fasting glucose following GDM and 44 European, 16 South Asian and 19 Afro-Caribbean controls to assess insulin action and secretion., Results: European post-GDM women had lower insulin sensitivity by FSIVGTT [0.6 (0.1-5.1) vs 1.5 (0.8-2.8) x10(-4).min(-1).pmol(-1).l(-1), p=0.010, adjusted for BMI p=0.054] and by HOMA [72(22-235) vs 153(55-421)%, p=0.004, adjusted for BMI p=0.006], and reduced -cell function [lower disposition index 0.05(0.01-0.40) vs 0.11(0.05-0.25)min(-1), p=0.017] compared with controls. South Asian post-GDM women had decreased -cell function [lower HOMA (%B) (73 (37-147) vs 124 (59-262) %, p=0.048 and acute insulin response to glucose (463 (131-1639) vs 1039 (393-2748) pmol/l h, p=0.052] than controls. Afro-Caribbean post-GDM women had lower glucose disappearance rate [1.3(0.6-2.8) vs 2.6 (1.8-3.8) 10(-2)/min, p=0.003] than controls, suggesting subtle glucose intolerance., Conclusions: Women with a history of GDM of three different ethnic groups, even in the presence of normal fasting glucose, display a range of metabolic abnormalities, including -cell dysfunction with variable insulin resistance. These derangements may be influenced by ethnicity.
- Published
- 2007
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