One Year Follow-up Study of Insulin Secretion and Insulin Resistance of Postpartum Women with History of Different Glucose Tolerance

Abstract

Objective To compare the insulin secretion, insulin resistance, blood fat and blood pressure differences of postpartum Chinese women with the history of different glucose tolerance. Methods A total of 336 gestational diabetes mellitus (GDM), gestational impair glucose tolerance(GIGT) and normal glucose tolerance(NGT) pregnant women diagnosed in the Second People's Hospital of Changzhou from November 2009 to August 2012 were observed, then an one year follow-up study was executed on those postpartum women with the history of different glucose tolerance but exclude those had been treated with drugs because of serious hyperglycemia in postpartum women with GDM history.We got a total of 95 cases as study subjects, according to glucose tolerance during pregnancy, they were divided into GDM group (n=22), GIGT group (n=41) and NGT group(n=32), then according to 75 g oral glucose tolerance test(OGTT) during pregnancy, GIGT group had been divided into three subgroups: 1-hour abnormal blood glucose subgroup(GIGT1, n=11), 2-hour abnormal blood glucose subgroup(GIGT2, n=18) and 3-hour abnormal blood glucose subgroup(GIGT3, n=12). Then the 75 g OGTT, fasting blood insulin(FINS), fasting plasma glucose(FPG), total cholesterol(TCH), triglyceride(TG), low-density lipoproteincholesterol(LDL-C), high-density lipoproteincholesterol(HDL-C) were detected and systolic blood pressure(SBP), diastolic blood pressure(DBP) were measured and body mass index (BMI), insulin secretion function index(IFI), homeostasis model assessment of insulin resistance(HOMA-IR) were calculated.The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of Changzhou No.2 People's Hospital. Informed consent was obtained from each participating patient. Results The results were: ①The FPG, 75 g OGTT 2 h, HOMA-IR, BMI, TCH, TG and LDL-C levels of GDM group were statistically higher than those of GIGT group or NGT group(P 0.05); There were no significant differences of FPG, IFI, HOMA-IR, TCH, TG and LDL-C levels between GIGT group and NGT group(P>0.05). ③The IFI level of GIGT1 subgroup was statistically lower than that of GIGT2 subgroup or GIGT3 subgroup(P 0.05); There were no significant differences of IFI and HOMA-IR levels between GIGT2 subgroup and GIGT3 subgroup(P>0.05). Conclusions Compared with postpartum women with GIGT history or NGT history, Chinese postpartum women with GDM history show easier of impairments of both insulin secretion and insulin sensitivity and lipid metabolic disorders.Compared with 2-hour or 3-hour abnormal blood glucose value postpartum women with GIGT history, 1-hour abnormal blood glucose value postpartum women with GIGT history show easier of impairments of both insulin secretion and insulin sensitivity. Key words: Diabetes, gestational; Glucose tolerance test; Postpartum period; Insulin resistance