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Endocrinology

Gestational Diabetes Doesn't Alter Metabolic Processes in Obese Pregnant Women

Strategic Insights

— 2 min read

Research conducted at Case Western Reserve University has found that gestational diabetes mellitus (GDM) does not alter metabolic processes in obese pregnant women. The study, published in the American Journal of Physiology-Endocrinology and Metabolism, investigated changes in energy expenditure and fat accretion in women with normal glucose tolerance (NGT) and GDM. The researchers found that while there was an approximately 30% increase in basal energy expenditure from pre-pregnancy to late pregnancy, there was no significant difference between the NGT and GDM groups. The study also found that obese subjects showed a significant 50%-80% increase in basal fat oxidation, particularly from time E to L, when there was increased accretion of adipose tissue and decreasing insulin sensitivity.

Key Takeaways:

  • The study recruited 15 healthy obese women before a planned pregnancy to participate in this study, with 7 of the women at high risk of developing GDM due to a history of GDM in a previous pregnancy, a strong family history of type 2 diabetes in a first-degree relative, or an impaired glucose tolerance test before conception.
  • All subjects were evaluated before conception, in early gestation (12-14 weeks), and again in late gestation (34-36 weeks), with 12 of the 15 subjects evaluated in the follicular phase of the menstrual cycle and 3 evaluated in the luteal phase.
  • The study found no significant differences in caloric intake, percentages of protein, lipids, or carbohydrates in diets, or physical activity between the NGT and GDM groups.
  • The researchers reported a significant inverse correlation between changes in basal endogenous glucose production and fat oxidation from time P to E.
  • There was a significant 50%-80% increase in basal fat oxidation in obese subjects, particularly from time E to L, when there was increased accretion of adipose tissue and decreasing insulin sensitivity.
  • The metabolic changes during insulin infusion in late gestation in obese women are similar to what was observed in lean women.
  • The study found that the pre-pregnancy metabolic status of the individual, and not whether or not the individual develops GDM, provides the baseline upon which the alterations in pregnancy metabolism are mediated.

Statistics:

  • Approximately 30% increase in basal energy expenditure from pre-pregnancy to late pregnancy.
  • 14% increase in the NGT group and 21% increase in the GDM subjects, although these differences did not reach statistical significance.
  • 50%-80% increase in basal fat oxidation in obese subjects.
  • 5-fold increase in fat oxidation with advancing gestation during fasting.
  • 48 hours: the time frame in which maternal leptin concentrations fall after delivery.

Sources:

  • American Journal of Physiology-Endocrinology and Metabolism
  • Health & Medicine Week via NewsRx.com & NewsRx.net.

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