Longitudinal changes in basal hepatic glucose production and suppression during insulin infusion in normal pregnant women
Abstract
Objective The purpose of this study was to evaluate basal endogenous glucose production and suppression during insulin infusion in normal pregnant women. Study design This prospective, longitudinal study was conducted at the Medical Center Hospital of Vermont. Six healthy women were evaluated before conception and at 12 to 14 and 34 to 36 weeks' gestation. Body composition was estimated by hydrodensitometry. Basal endogenous glucose production was estimated with a primed constant infusion of 6-6 2H2 glucose, and suppression of endogenous glucose production was estimated with insulin infusion during a hyperinsulinemic-euglycemic clamp. Results There was a significant (p = 0.02) 65% increase in fasting insulin concentration by late gestation. Moreover, there was a significant 30% (p = 0.0005) increase in basal endogenous glucose production (mg/min) with advancing gestation, which remained significant (p = 0.05) when corrected for fat-free mass. During insulin infusion endogenous glucose production was almost completely suppressed (i.e., > 90%) throughout gestation. Conclusions There is a significant increase in basal endogenous glucose production at 34 to 36 weeks' gestation in spite of a significant increase in fasting insulin concentration. However, endogenous glucose production remains sensitive to insulin infusion throughout gestation.
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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 [17]
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Diabetes Mellitus Complicating Pregnancy
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- Authors
- Catalano, P. M., Tyzbir, E. D., Wolfe, R. R., Roman, N. M., B. Amini, S., & 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
- 1992-10
- Volume
- 167
- Issue
- 4
- Pages
- 913-919
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2022691572
- Cited by
- 194
- References
- 17
- Citations by year
- 2025: 2 · 2024: 13 · 2023: 8 · 2022: 11 · 2021: 9 · 2020: 12 · 2019: 12 · 2018: 9 · 2017: 6 · 2016: 14 · 2015: 5 · 2014: 5 · 2013: 6 · 2012: 9
- FWCI
- 1.73
- 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)
- National Center for Research Resources (GCRC-RR-109, GCRC RR-00210)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- hepatic glucose production, insulin infusion, hyperinsulinemic-euglycemic clamp, fasting insulin, pregnancy, gestational changes, fat-free mass, insulin sensitivity, body composition
- MeSH terms
- Adult, Female, Glucose, Humans, Insulin, Insulin Infusion Systems, Liver, Pregnancy, Reference Values, Glucose Clamp Technique
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