Carbohydrate metabolism during pregnancy in control subjects and women with gestational diabetes
Abstract
The purpose of this study was to characterize carbohydrate metabolism associated with the development of gestational diabetes. Six control (Ctl) and ten women with gestational diabetes mellitus (GDM) were evaluated using an intravenous glucose tolerance test and hyperinsulinemic-euglycemic clamp with [6,6-2H2]glucose prior to conception (P) and at 12-14 (E), and 34-36 wk of gestation (L). There was an increase (P = 0.0001) in first-phase insulin response in Ctl (P 174 +/- 133, E 388 +/- 120, and L 587 +/- 303 microU/ml) and GDM (P 197 +/- 94, E 267 +/- 77, and L 376 +/- 162 microU/ml) but a significant (P = 0.02) lag in change in GDM with advancing gestation. Basal endogenous glucose production increased during gestation [Ctl: P 2.74 +/- 0.23, E 2.62 +/- 0.38, and L 3.14 +/- 0.36; GDM: P 2.68 +/- 0.51, E 2.78 +/- 0.45, and L 2.98 +/- 0.48 mg.kg fat-free mass (FFM)-1 x min-1; P = 0.02], but there was resistance to suppression by insulin infusion (P = 0.03) in late gestation (GDM: 0.61 +/- 0.44 vs. Ctl: 0.16 +/- 0.17 mg.kg FFM-1 x min-1). Insulin sensitivity decreased during gestation (Ctl: P 10.78 +/- 2.78, E 8.34 +/- 2.36, and L 4.75 +/- 1.22; GDM: P 7.49 +/- 2.13, E 7.40 +/- 1.45, and L 4.21 +/- 1.01 mg.kg FFM-1 x min-1; P = 0.0001) and was primarily decreased (P = 0.04) in GDM compared with Ctl from P through E. These findings closely resemble those of non-insulin-dependent, predominantly insulin-resistant diabetes, which is often a sequel of GDM.
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Elevated plasma insulin may inhibit fatty acid oxidation, and impaired triglyceride oxidation may contribute to macrosomia.
“Elevated plasma insulin may inhibit fatty acid oxidation, and impaired triglyceride oxidation triglycerides may contribute to macrosomia [18,26].”
From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [26]
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- Authors
- Catalano, P. M., Tyzbir, E. D., Wolfe, R. R., Calles, J., Roman, N. M., Amini, S. B., & Sims, E. A.
- Affiliations
- University of Vermont (US)
- Venue
- American Journal of Physiology-Endocrinology and Metabolism
- Publisher
- American Physiological Society
- Published
- 1993-01-01
- Volume
- 264
- Issue
- 1
- Pages
- E60-E67
- ISSN
- 0193-1849 (ISSN-L)
- 1522-1555
- OpenAlex
- W1917860558
- Cited by
- 484
- References
- 7
- Citations by year
- 2026: 3 · 2025: 14 · 2024: 13 · 2023: 17 · 2022: 16 · 2021: 27 · 2020: 26 · 2019: 16 · 2018: 21 · 2017: 19 · 2016: 18 · 2015: 22 · 2014: 24 · 2013: 22 · 2012: 17
- FWCI
- 6.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physiology-Endocrinology and Metabolism (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
- gestational diabetes mellitus, carbohydrate metabolism, insulin sensitivity, insulin resistance, first-phase insulin response, endogenous glucose production, hyperinsulinemic-euglycemic clamp, pregnancy
- MeSH terms
- Adult, Female, Glucose, Glucose Tolerance Test, Humans, Hyperinsulinism, Injections, Intravenous, Insulin, Insulin Resistance, Pregnancy, Reference Values, Glucose Clamp Technique, Diabetes, Gestational, Carbohydrate Metabolism
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