Hyperinsulinemia during pregnancy across varying degrees of glucose tolerance: An examination of the Kraft database. Issue 5 (4th March 2021)

• Record Type: Journal Article
• Authors: North, Sylvia; Zinn, Caryn; Crofts, Catherine
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 47:Issue 5(2021)
• Page Start: 1719
• Page End: 1726
• Publication Date: 2021-03-04
• Subjects: gestational diabetes -- hyperinsulinaemia -- hyperinsulinemia -- insulin resistance -- Kraft patterns; Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.14731
• Languages: English
• ISSNs: 1341-8076

Abstract

Abstract: Aim: Hyperinsulinemia is a known underlying driver of metabolic disease; however, its role in pregnancy complications is less understood due to insulin measurement not being a part of standard clinical assessments. This study aimed to characterize hyperinsulinemia in pregnancy by gestational diabetes (GD) status using Kraft methodology. Methods: We analyzed historical data from 926 pregnant women who underwent a 100‐g oral glucose tolerance test (OGTT), which included insulin measurement. Subjects were grouped by GD diagnosis status ("Normal", "Borderline", "GD") and insulin responses over 3 h were compared between groups. Results: "GD" was diagnosed in 20.3% of the subjects and 13.8% were grouped as "Borderline." The prevalence of hyperinsulinemia using the Kraft algorithm was 33.1% for Kraft IIB and 42.0% for Kraft III. Compared to normal glucose‐tolerant mothers, individuals from the "Borderline" group had an exacerbated insulin response, although not to the same magnitude as those with "GD." Conclusions: Dynamic OGTT insulin measurement during pregnancy may provide a meaningful assessment of metabolic risk among women who would otherwise not be diagnosed with GD.