Beta cell dysfunction and its clinical significance in gestational diabetes

Yoshifumi Saisho, Kei Miyakoshi, Mamoru Tanaka, Akira Shimada, Satoru Ikenoue, Ikuko Kadohira, Yasunori Yoshimura, Hiroshi Itoh

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

The aim of this study is to explore beta cell dysfunction and its clinical significance in gestational diabetes mellitus (GDM). We assessed insulin sensitivity and insulin secretion in a total of 277 Japanese women between 24 and 27 weeks of pregnancy who underwent a 2 h, 75 g oral glucose tolerance test (OGTT) because of an abnormal result on a 1 h 50 g oral glucose challenge conducted as part of a standard screening for GDM. Insulin sensitivity was evaluated by an insulin sensitivity index derived from OGTT (ISOGTT), whereas insulin secretion was calculated as a ratio of the total area under the insulin curve to the total area under the glucose curve (AUCins/glu). Beta cell function in relation to insulin sensitivity (i.e. disposition index) was derived from the product of insulin sensitivity and insulin secretion (i.e. AUCins/glu × ISOGTT). In women diagnosed with GDM (n=57), the disposition index was significantly lower than that in those without GDM, irrespective of obesity. The disposition index in women with GDM was significantly correlated with levels of fasting and mean preprandial capillary glucose and HbA1c before initiating insulin therapy (r = -0.45, -0.38, -0.49, respectively). Furthermore, there was a significant correlation between the disposition index and total insulin dosage to achieve glycemic goal (r = -0.41). In conclusion, we demonstrated beta cell dysfunction in Japanese women with GDM irrespective of obesity. The level of beta cell dysfunction in GDM was associated with the severity of glucose intolerance and total insulin dosage required. These findings underpin clinical significance of beta cell dysfunction in GDM.

Original languageEnglish
Pages (from-to)973-980
Number of pages8
JournalEndocrine Journal
Volume57
Issue number11
DOIs
Publication statusPublished - 2010

Fingerprint

Gestational Diabetes
Insulin
Insulin Resistance
Glucose Tolerance Test
Glucose
Area Under Curve
Obesity
Glucose Intolerance
Fasting
Pregnancy

Keywords

  • Asian
  • Disposition index
  • Glucose metabolism
  • Insulin secretion
  • Insulin sensitivity

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Beta cell dysfunction and its clinical significance in gestational diabetes. / Saisho, Yoshifumi; Miyakoshi, Kei; Tanaka, Mamoru; Shimada, Akira; Ikenoue, Satoru; Kadohira, Ikuko; Yoshimura, Yasunori; Itoh, Hiroshi.

In: Endocrine Journal, Vol. 57, No. 11, 2010, p. 973-980.

Research output: Contribution to journalArticle

@article{b386c48b4e6342148ff6f00262ac9a91,
title = "Beta cell dysfunction and its clinical significance in gestational diabetes",
abstract = "The aim of this study is to explore beta cell dysfunction and its clinical significance in gestational diabetes mellitus (GDM). We assessed insulin sensitivity and insulin secretion in a total of 277 Japanese women between 24 and 27 weeks of pregnancy who underwent a 2 h, 75 g oral glucose tolerance test (OGTT) because of an abnormal result on a 1 h 50 g oral glucose challenge conducted as part of a standard screening for GDM. Insulin sensitivity was evaluated by an insulin sensitivity index derived from OGTT (ISOGTT), whereas insulin secretion was calculated as a ratio of the total area under the insulin curve to the total area under the glucose curve (AUCins/glu). Beta cell function in relation to insulin sensitivity (i.e. disposition index) was derived from the product of insulin sensitivity and insulin secretion (i.e. AUCins/glu × ISOGTT). In women diagnosed with GDM (n=57), the disposition index was significantly lower than that in those without GDM, irrespective of obesity. The disposition index in women with GDM was significantly correlated with levels of fasting and mean preprandial capillary glucose and HbA1c before initiating insulin therapy (r = -0.45, -0.38, -0.49, respectively). Furthermore, there was a significant correlation between the disposition index and total insulin dosage to achieve glycemic goal (r = -0.41). In conclusion, we demonstrated beta cell dysfunction in Japanese women with GDM irrespective of obesity. The level of beta cell dysfunction in GDM was associated with the severity of glucose intolerance and total insulin dosage required. These findings underpin clinical significance of beta cell dysfunction in GDM.",
keywords = "Asian, Disposition index, Glucose metabolism, Insulin secretion, Insulin sensitivity",
author = "Yoshifumi Saisho and Kei Miyakoshi and Mamoru Tanaka and Akira Shimada and Satoru Ikenoue and Ikuko Kadohira and Yasunori Yoshimura and Hiroshi Itoh",
year = "2010",
doi = "10.1507/endocrj.K10E-231",
language = "English",
volume = "57",
pages = "973--980",
journal = "Endocrine Journal",
issn = "0918-8959",
publisher = "Japan Endocrine Society",
number = "11",

}

TY - JOUR

T1 - Beta cell dysfunction and its clinical significance in gestational diabetes

AU - Saisho, Yoshifumi

AU - Miyakoshi, Kei

AU - Tanaka, Mamoru

AU - Shimada, Akira

AU - Ikenoue, Satoru

AU - Kadohira, Ikuko

AU - Yoshimura, Yasunori

AU - Itoh, Hiroshi

PY - 2010

Y1 - 2010

N2 - The aim of this study is to explore beta cell dysfunction and its clinical significance in gestational diabetes mellitus (GDM). We assessed insulin sensitivity and insulin secretion in a total of 277 Japanese women between 24 and 27 weeks of pregnancy who underwent a 2 h, 75 g oral glucose tolerance test (OGTT) because of an abnormal result on a 1 h 50 g oral glucose challenge conducted as part of a standard screening for GDM. Insulin sensitivity was evaluated by an insulin sensitivity index derived from OGTT (ISOGTT), whereas insulin secretion was calculated as a ratio of the total area under the insulin curve to the total area under the glucose curve (AUCins/glu). Beta cell function in relation to insulin sensitivity (i.e. disposition index) was derived from the product of insulin sensitivity and insulin secretion (i.e. AUCins/glu × ISOGTT). In women diagnosed with GDM (n=57), the disposition index was significantly lower than that in those without GDM, irrespective of obesity. The disposition index in women with GDM was significantly correlated with levels of fasting and mean preprandial capillary glucose and HbA1c before initiating insulin therapy (r = -0.45, -0.38, -0.49, respectively). Furthermore, there was a significant correlation between the disposition index and total insulin dosage to achieve glycemic goal (r = -0.41). In conclusion, we demonstrated beta cell dysfunction in Japanese women with GDM irrespective of obesity. The level of beta cell dysfunction in GDM was associated with the severity of glucose intolerance and total insulin dosage required. These findings underpin clinical significance of beta cell dysfunction in GDM.

AB - The aim of this study is to explore beta cell dysfunction and its clinical significance in gestational diabetes mellitus (GDM). We assessed insulin sensitivity and insulin secretion in a total of 277 Japanese women between 24 and 27 weeks of pregnancy who underwent a 2 h, 75 g oral glucose tolerance test (OGTT) because of an abnormal result on a 1 h 50 g oral glucose challenge conducted as part of a standard screening for GDM. Insulin sensitivity was evaluated by an insulin sensitivity index derived from OGTT (ISOGTT), whereas insulin secretion was calculated as a ratio of the total area under the insulin curve to the total area under the glucose curve (AUCins/glu). Beta cell function in relation to insulin sensitivity (i.e. disposition index) was derived from the product of insulin sensitivity and insulin secretion (i.e. AUCins/glu × ISOGTT). In women diagnosed with GDM (n=57), the disposition index was significantly lower than that in those without GDM, irrespective of obesity. The disposition index in women with GDM was significantly correlated with levels of fasting and mean preprandial capillary glucose and HbA1c before initiating insulin therapy (r = -0.45, -0.38, -0.49, respectively). Furthermore, there was a significant correlation between the disposition index and total insulin dosage to achieve glycemic goal (r = -0.41). In conclusion, we demonstrated beta cell dysfunction in Japanese women with GDM irrespective of obesity. The level of beta cell dysfunction in GDM was associated with the severity of glucose intolerance and total insulin dosage required. These findings underpin clinical significance of beta cell dysfunction in GDM.

KW - Asian

KW - Disposition index

KW - Glucose metabolism

KW - Insulin secretion

KW - Insulin sensitivity

UR - http://www.scopus.com/inward/record.url?scp=78649794987&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78649794987&partnerID=8YFLogxK

U2 - 10.1507/endocrj.K10E-231

DO - 10.1507/endocrj.K10E-231

M3 - Article

C2 - 20847480

AN - SCOPUS:78649794987

VL - 57

SP - 973

EP - 980

JO - Endocrine Journal

JF - Endocrine Journal

SN - 0918-8959

IS - 11

ER -