scholarly journals Higher Concentrations of BCAAs and 3-HIB Are Associated with Insulin Resistance in the Transition from Gestational Diabetes to Type 2 Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Ulrika Andersson-Hall ◽  
Carolina Gustavsson ◽  
Anders Pedersen ◽  
Daniel Malmodin ◽  
Louise Joelsson ◽  
...  

Aim. Determine the metabolic profile and identify risk factors of women transitioning from gestational diabetes mellitus (GDM) to type 2 diabetes mellitus (T2DM). Methods. 237 women diagnosed with GDM underwent an oral glucose tolerance test (OGTT), anthropometrics assessment, and completed lifestyle questionnaires six years after pregnancy. Blood was analysed for clinical variables (e.g., insulin, glucose, HbA1c, adiponectin, leptin, and lipid levels) and NMR metabolomics. Based on the OGTT, women were divided into three groups: normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and T2DM. Results. Six years after GDM, 19% of subjects had T2DM and 19% IGT. After BMI adjustment, the IGT group had lower HDL, higher leptin, and higher free fatty acid (FFA) levels, and the T2DM group higher triglyceride, FFA, and C-reactive protein levels than the NGT group. IGT and T2DM groups reported lower physical activity. NMR measurements revealed that levels of branched-chain amino acids (BCAAs) and the valine metabolite 3-hydroxyisobyturate were higher in T2DM and IGT groups and correlated with measures of insulin resistance and lipid metabolism. Conclusion. In addition to well-known clinical risk factors, BCAAs and 3-hydroxyisobyturate are potential markers to be evaluated as predictors of metabolic risk after pregnancy complicated by GDM.

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Timea Tänczer ◽  
Márk M. Svébis ◽  
Beatrix Domján ◽  
Viktor J. Horváth ◽  
Adam G. Tabák

Objective. Monophasic glucose response (MGR) during an oral glucose tolerance test (OGTT) and gestational diabetes mellitus (GDM) are predictors of type 2 diabetes mellitus (T2DM). We investigated the association between current MGR and (1) glucose tolerance during a pregnancy 3 years before and (2) current glucose tolerance status. We also sought (3) other determinants of MGR. Research Design and Methods. We conducted a nested case-control study of GDM (n=47 early GDM, diagnosed between 16 and 20 weeks of gestation; n=40 late GDM, diagnosed between 24 and 28 weeks of gestation) and matched healthy controls (n=37, normal glucose tolerance during pregnancy) all free from diabetes at follow-up 3.4±0.6 years after delivery. Glucose tolerance was determined by 2-hour 75 g OGTT. Monophasic and biphasic groups were defined based on serum glucose measurements during OGTT. Results. The biphasic group was younger, had lower triglyceride levels and area under the OGTT glucose curve, and was less frequently diagnosed with early GDM (25 vs. 45%, all p<0.05). Women with a biphasic response also tended to have lower systolic blood pressure (p<0.1). No differences were found in fasting and 2-hour glucose and insulin levels, or BMI. According to multiple logistic regression, MGR was associated with prior early GDM (OR 2.14, 95% CI 0.92-4.99) and elevated triglyceride levels (OR 2.28, 95% CI 1.03-5.03/log (mmol/l)). Conclusions. We found that more severe, early-onset GDM was an independent predictor of monophasic glucose response suggesting that monophasic response may represent an intermediate state between GDM and manifest type 2 diabetes.


2014 ◽  
Vol 60 (1) ◽  
pp. 32-35
Author(s):  
E A Shestakova ◽  
A V Ilyin ◽  
A D Deev ◽  
M V Shestakova ◽  
I I Dedov

The study included 127 patients with type 2 diabetes (T2D) risk factors, who underwent oral glucose tolerance test (75 g glucose) with pancreatic and incretin hormones estimated in fasting state, at 30 and 120 minutes after glucose load. According to the test results the population was divided into 3 groups: group with normal glucose tolerance (NGT), group with high risk of diabetes developing (impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG)) and newly-diagnosed T2D. The stimulated glucagon secretion was suppressed in NGT group, whereas in T2D patients there was an increase in glucagon levels at 30 min after the glucose load. Within high risk group the area under curve (AUC) of glucagon secretion was significantly elevated in IFG patients comparing to IGT (0,52 vs 0,07 ng·ml-1·min-1, р=0,0005). AUC of glucagon secretion was positively related only to fasting glucagon-like peptide 2 (GLP-2) level (r=0,61, р=0,0001), that suggests glucagonotropic properties for GLP-2. We conclude that glucagon stimulation by GLP-2 may play a role in decreased glucagon suppression in T2D patients and IFG state development.


2012 ◽  
Vol 167 (4) ◽  
pp. 561-567 ◽  
Author(s):  
Jelena Todoric ◽  
Ammon Handisurya ◽  
Thomas Perkmann ◽  
Bernhard Knapp ◽  
Oswald Wagner ◽  
...  

ObjectiveProgranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the role of PGRN in gestational diabetes mellitus (GDM), which is regarded as a model for early type 2 diabetes.MethodsPGRN serum levels were measured in 90 pregnant women (45 GDM and 45 normal glucose tolerance (NGT)). In addition, PGRN was measured during a 2-h, 75 g oral glucose tolerance test in 20 pregnant women (ten GDM and ten NGT) and in 16 of them post partum (ten GDM and six NGT).ResultsPGRN concentrations were significantly higher in pregnant women compared with post partum levels (536.79±31.81 vs 241.53±8.86, P<0.001). Multivariate regression analyses showed a strong positive correlation of PGRN with estrogen and progesterone. The insulinogenic index, a marker of early insulin secretion, displayed a positive correlation with PGRN, both during and after pregnancy (R=0.47, P=0.034; R=0.63, P=0.012). HbA1c and the oral glucose insulin sensitivity index showed significant post partum associations with PGRN (R=0.43, P=0.049; R=−0.65, P=0.009).ConclusionsPGRN concentrations are markedly lower after pregnancy regardless of the gestational glucose tolerance state. PGRN levels per se do not discriminate between mild GDM and NGT in pregnant women. Therefore, the development of GDM appears to be due to impaired β-cell function that is not related to PGRN effect.


Author(s):  
VV Boeva ◽  
TA Boeva ◽  
AN Zavyalov

In order to assess the diagnosis of carbohydrate metabolism disorders, day care patients from Tambov central regional hospital were investigated. The study was conducted during 6 months in 2018. The study included 91 patients and allowed the diagnosis of type 2 diabetes mellitus (DM) in 31 (34.0%) cases, 6 (6.5%) impaired fasting glucose and 22 (24.1%) impaired glucose tolerance. This survey highlighted the necessity to expand the screening populations at risk for developing type 2 diabetes. The rational for the 75-gram oral glucose tolerance test for all individuals with fasting plasma glucose ≥ 5.6 ≤ 6.0 mmol/l and having one or more risk factors for developing type 2 diabetes and / or metabolic syndrome is shown. Among these categories diabetes was detected in 4.3%, and prediabetes in 14.4% of cases.


2000 ◽  
pp. 681-686 ◽  
Author(s):  
AE Pontiroli ◽  
LD Monti ◽  
S Costa ◽  
PE Sandoli ◽  
A Pizzini ◽  
...  

OBJECTIVES: To evaluate the frequency of impaired glucose tolerance (IGT) and of Type 2 diabetes mellitus (Type 2 DM) in siblings of patients with Type 2 DM, and to assess insulin release and insulin sensitivity in siblings with normal glucose tolerance (NGT), compared with NGT spouses of probands without family history of Type 2 DM. DESIGN AND METHODS: We evaluated 87 families including 103 Type 2 DM patients (87 probands), and we carried out an oral glucose tolerance test (OGTT) in 130 siblings and in 60 spouses. Among NGT subjects, 12 siblings and 16 spouses underwent a low-dose insulin-glucose infusion test (LDIGIT) to evaluate C-peptide release and insulin sensitivity. RESULTS: After the OGTT, 24 siblings were classified as having Type 2 DM, 31 as IGT, and only 14 spouses as IGT (P=0.0012 vs siblings). NGT siblings (n=75) showed higher insulin levels at 120 min than NGT spouses (n=46) at OGTT, in spite of identical blood glucose levels; at LDIGIT, NGT siblings secreted more C-peptide and showed a lower insulin sensitivity than NGT spouses. CONCLUSIONS: These data indicate that middle-aged siblings of probands with Type 2 DM have a high frequency of IGT and Type 2 DM, and that NGT siblings have increased insulin resistance and increased insulin secretion when compared with adequate controls.


2011 ◽  
Vol 2011 ◽  
pp. 1-8
Author(s):  
Guang Yin ◽  
Keizo Ohnaka ◽  
Makiko Morita ◽  
Shinji Tabata ◽  
Osamu Tajima ◽  
...  

This study investigated the association of ADH1B (rs1229984) and ALDH2 (rs671) polymorphisms with glucose tolerance status, as determined by a 75-g oral glucose tolerance test, and effect modification of these polymorphisms on the association between alcohol consumption and glucose intolerance in male officials of the Self-Defense Forces. The study subjects included 1520 men with normal glucose tolerance, 553 with prediabetic condition (impaired fasting glucose and impaired glucose tolerance), and 235 men with type 2 diabetes. There was an evident interaction between alcohol consumption and ADH1B polymorphism in relation to type 2 diabetes (interaction P=.03). The ALDH2487Lys allele was associated with a decreased prevalence odds of type 2 diabetes regardless of alcohol consumption. In conclusion, the ADH1B polymorphism modified the association between alcohol consumption and type 2 diabetes. A positive association between alcohol consumption and type 2 diabetes was confounded by ALDH2 polymorphism.


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