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Diabetes Care 28:1207-1208, 2005
© 2005 by the American Diabetes Association, Inc.

Clinical Care/Education/Nutrition
Brief Report

Early Pregnancy Insulin Resistance and Subsequent Gestational Diabetes Mellitus

Karen V. Smirnakis, MD, PHD, MPH1, Abelardo Martinez, MD1, Karen Hsu Blatman, BA1, Myles Wolf, MS, MMSC1, Jeffrey L. Ecker, MD2 and Ravi Thadhani, MD, MPH1,2

1 Renal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
2 Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

Address correspondence and reprint requests to Karen V. Smirnakis, MD, PhD, MPH, GRB 1003, Renal Unit, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114. Email: ksmirnakis@partners.org

Abbreviations: GDM, gestational diabetes mellitus • GLT, glucose loading test • HOMA, homeostasis model assessment

The first 20% of the full text of this article appears below.


   INTRODUCTION
 
Gestational diabetes mellitus (GDM), which complicates 3–7% of all pregnancies, is associated with increased maternal and fetal morbidity (1). Identification of early risk markers may result in improved understanding of disease pathogenesis and identification of potential targets for intervention. We sought to determine the association between early pregnancy insulin resistance and subsequent abnormal glucose tolerance in pregnancy.


   RESEARCH DESIGN AND METHODS
 
We conducted two institutional review board–approved, prospective, nested, case-control studies within Massachusetts General Hospital’s Obstetrical Maternal Study (MOMS) comparing subjects with GDM and subjects with abnormal glucose loading test (GLT) results but no GDM with control subjects. Consecutive MOMS participants with singleton gestations between February 2002 and February 2004 who provided fasting blood samples between 16–18 weeks’ gestation, underwent GLT testing at 24–28 weeks’ gestation, and delivered after 34 weeks were eligible. To limit confounding . . . [Full Text of this Article]


   RESULTS
 

   CONCLUSIONS
 

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Copyright © 2005 by the American Diabetes Association.