Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women
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.
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As pregnancy progresses, a surge of local and placental hormones, including estrogen, progesterone, leptin, cortisol, placental lactogen, and placental growth hormone, promotes a state of insulin resistance.
“However, as pregnancy progresses, a surge of local and placental hormones, including estrogen, progesterone, leptin, cortisol, placental lactogen, and placental growth hormone together promote a state of insulin resistance [6].”
From The Pathophysiology of Gestational Diabetes Mellitus (2018) · cites this paper as [6]
Insulin secretion in response to oral glucose increases by at least 120% in the first trimester.
“However, insulin secretion in response to oral glucose increases by at least 120% in the first trimester [16,17,18].”
From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [16]
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- Authors
- Catalano, P. M., Tyzbir, E. D., Roman, N. M., Amini, S. B., & Sims, E. A. H.
- Affiliations
- University of Vermont (US)
- Corresponding author
- Catalano, Patrick M.
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 1991-12
- Volume
- 165
- Issue
- 6
- Pages
- 1667-1672
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2036633211
- Cited by
- 709
- References
- 2
- Citations by year
- 2026: 25 · 2025: 33 · 2024: 36 · 2023: 32 · 2022: 48 · 2021: 56 · 2020: 47 · 2019: 26 · 2018: 37 · 2017: 29 · 2016: 23 · 2015: 34 · 2014: 29 · 2013: 18 · 2012: 25
- FWCI
- 4.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5m01rr000210-26)
- U.S. Public Health Service (22965-01)
- National Center for Research Resources (RR-00210, RR109)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- insulin secretion, insulin resistance, pregnancy, non-obese women, insulin sensitivity, first-phase insulin response, second-phase insulin response, insulin/glucose ratio, hyperinsulinemic-euglycemic clamp, glucose infusion rate, body composition
- MeSH terms
- Insulin Secretion, Administration, Oral, Adult, Blood Glucose, Female, Glucose Tolerance Test, Humans, Infusions, Intravenous, Insulin, Insulin Resistance, Pregnancy, Prospective Studies
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