Abstract
To compare changes in maternal insulin sensitivity (IS), insulin response (IR) and disposition index (DI) from late pregnant (PP0:34-37 weeks) to early postpartum (PP1: 1-5 days after delivery) and late postpartum (PP2: 6-12 weeks after delivery) and to correlate the results to changes in maternal lipids, adipokines and lipids over the same time interval in women with gestational diabetes (GDM). This is a secondary analysis from a previously reported cohort of 27 women with GDM. Subjects were eligible with a singleton pregnancy ≥34 weeks, no pre-existing diabetes, evidence of infection, or medication for glucose control post-partum. Subjects underwent an OGTT at three points (PP0, PP1, PP2) with assessment of fasting lipids (cholesterol, LDL, HDL, VLDL, triglycerides), cytokines (IL6, IL8, CRP, TNFα), adiponectin and leptin. Maternal serum for insulin and glucose were collected for measures of IS (ISogtt), IR (Stumvoll method) and DI (IS*IR). The IS, IR and DI were compared at PP0, PP1 and PP2. The correlation between changes in IS, IR and DI and lipid/cytokine measures were made at PP0 vs. PP1 and PP0 vs. PP2. The changes in IS, IR and DI over time and are shown in Figure 1. Changes in maternal lipids and cytokines are in Table 1.There were significant correlations between changes in IR and Leptin from PP0 to PP1 (r=-0.37, p=0.05) and changes in IS and Triglyceride from PP0 to PP2 (r=-0.40, p=0.04). There is a significant improvement in IS and DI and decrease in IR immediately PP. The changes in glucose metabolism are independent of changes in lipids and cytokines and maternal weight. The placental factors relating to changes in glucose metabolism in GDM pregnancy remain largely unknown. CDC, Battelle Memorial Institute (200-2008-27956, Task Order 23) and CTSC at Case Western Reserve University.View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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