Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women

doi:10.1016/0002-9378(91)90012-G

American Journal of Obstetrics and Gynecology

Volume 165, Issue 6, Part 1, December 1991, Pages 1667-1672

https://doi.org/10.1016/0002-9378(91)90012-G Get rights and content

Abstract

To assess the longitudinal changes in insulin release and insulin sensitivity in nonobese normal women during gestation, six women were evaluated with oral glucose tolerance testing, body composition analysis, intravenous glucose tolerance tests, and the hyperinsulinemic-euglycemic clamp before conception, at 12 to 14 weeks, and at 34 to 36 weeks' gestation. There was a significant increase in the insulin/glucose ratio (p = 0.028) during the oral glucose tolerance test during gestation. There was also a significant 3.0- to 3.5-fold increase throughout gestation in first-phase (p = 0.001) and second-phase (p = 0.0001) insulin release during the intravenous glucose tolerance test. Peripheral insulin sensitivity was estimated as the glucose infusion rate (in milligrams per kilogram fat-free mass per minute) during the hyperinsulinemic-euglycemic clamp. There was a significant (p = 0.0003) 56% decrease in insulin sensitivity through 36 weeks' gestation. These results are the first to prospectively evaluate the longitudinal changes in maternal carbohydrate metabolism from the time before conception through late gestation with newer methods such as the hyperinsulinemic-euglycemic clamp. (AM J OBSTET GYNECOL 1991;165: 1667-72.)

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: Presented in part at the Thirty-sixty Annual Meeting of the Society for Gynecologic Investigation, San Diego, California, March 15-18, 1989.

^a: From the Department of Obstetrics and Gynecology

^b: From the Endocrine-Metabolic Unit, Department of Medicine

^c: The University of Vermont College of Medicine, and the Department of Reproductive Biology, Case Western Reserve University

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Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women

Abstract

Am J Obstet Gynecol

Am J Obstet Gynecol

Am J Obstet Gynecol

Am J Obstet Gynecol

Metabolism

Metabolism

Maternal physiology in pregnancy. Obstetrics

Plasma insulin in normal late pregnancy

N Engl J Med

Further observations on reactivity to insulin in normal pregnancy

Obstet Gynecol

Carbohydrate and lipid metabolism during normal pregnancy: relationship to gestational hormonal action

Physiologic changes in normal pregnancy

Diabetes mellitus