Reduced GLP-1 secretion at 30 minutes after a 75-g oral glucose load is observed in gestational diabetes mellitus: a prospective cohort study
Author
Sukumar, NithyaBagias, Christos
Goljan, Ilona
Weldeselassie, Yonas
Gharanei, Seley
Tan, Bee K.
Holst, Jens J.
Saravanan, Ponnusamy
Affiliation
University of Warwick; George Eliot Hospital NHS Trust, Nuneaton; University of Leicester; University Hospitals of Leicester NHS Trust; University Hospital Birmingham NHS Foundation Trust; University of Copenhagen, DenmarkPublication date
2018-12Subject
Diabetes
Metadata
Show full item recordAbstract
Glucagon-like peptide 1 (GLP-1) levels may be reduced in type 2 diabetes, but whether a similar impairment exists in gestational diabetes mellitus (GDM) has not been established. We studied this in a prospective cohort study of pregnant women (n = 144) during oral glucose tolerance test (OGTT). GLP-1, glucose, and insulin were sampled at 30-min intervals during a 2-h 75-g OGTT, and indices of insulin secretion and sensitivity were calculated. In a nested case-control study, women with GDM (n = 19) had 12% lower total GLP-1 secretion area under the curve (AUC) compared with control subjects matched for age, ethnicity, and gestational age (n = 19), selected from within the lowest quartile of glucose120 min values in our cohort. GDM had lower GLP-1 response in the first 30 min (19% lower GLP-130 min and 17% lower AUC0-30 min) after adjustment for possible confounders. Their glucose levels began to diverge at 30 min of the OGTT with increasing insulin levels, and by 120 min, their insulin levels were three times higher. In a secondary cohort of 57 women that included "high-normal" glucose120 min values, low GLP-1 AUC0-30 min was independently associated with lower indices of insulin secretion and sensitivity. In conclusion, we have observed that women with GDM have lower GLP-1 response at 30 min of an OGTT and hyperglycemia at 120 min despite significant hyperinsulinemia.Citation
Sukumar N, Bagias C, Goljan I, Weldeselassie Y, Gharanei S, Tan BK, Holst JJ, Saravanan P. Reduced GLP-1 Secretion at 30 Minutes After a 75-g Oral Glucose Load Is Observed in Gestational Diabetes Mellitus: A Prospective Cohort Study. Diabetes. 2018 Dec;67(12):2650-2656. doi: 10.2337/db18-0254. Epub 2018 Sep 19.Type
ArticlePMID
30232211Journal
DiabetesPublisher
American Diabetes Associationae974a485f413a2113503eed53cd6c53
10.2337/db18-0254