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- Title
The impact of acute elevation of non-esterified fatty acids on insulin sensitivity and secretion in women with former gestational diabetes.
- Authors
McLachlan, K. A.; Alford, F. P.
- Abstract
Elevations in non-esterified fatty acids (NEFA) have been shown to decrease insulin action and secretion, and are a risk factor for the development of Type 2 diabetes. As women who have had gestational diabetes (GDM) are at increased risk of diabetes, we examined the effect of an acute elevation of NEFA on insulin secretion and action in these women.Nineteen women with recent former GDM and 19 age- and BMI-matched postpartum healthy control subjects underwent a 40-min intravenous glucose tolerance test, with and without a preceding 2-h infusion of 20% Intralipid. Insulin action was assessed by glucose disappearance (Kg) and insulin sensitivity (SI); insulin secretion by first phase insulin release (FPIR) and disposition index (DI).NEFA levels were similarly elevated in both groups by the Intralipid infusion (up to 1·140 ± 0·03 mm). As expected, the lipid infusion significantly reduced Kg (2·15 ± 0·13vs.1·69 ± 0·09/min,P < 0·001) and SI (3·14 ± 0·28vs.2·13 ± 0·17/min/mUl/min,P <0·001) in all subjects, and these were significant within the GDM and control subgroups. FPIR was elevated in the Intralipid study in the total group of women (4·50 ± 0·50vs.5·02 ± 0·53,P = 0·02), but DI was significantly reduced (12·13 ± 1·1vs.8·83 ± 0·7,P < 0·001). There was no significant difference, however, in the absolute or percentage change in Kg, SI or FPIR with lipid infusion between the GDM and control groups. GDM status was not a predictor of the response of Kg, SI or FPIR to lipid infusion, rather, adiposity (% fat), average fasting NEFA levels and basal disposition index were associated.These data suggest that women with former gestational diabetes, in contrast to other prediabetic states, are not more susceptible to the deleterious effects of an acute elevation in nonesterified fatty acids than matched control subjects.
- Subjects
INSULIN; PANCREATIC secretions; DIABETES in women; GESTATIONAL age; GLUCOSE tolerance tests; TYPE 2 diabetes
- Publication
Clinical Endocrinology, 2005, Vol 62, Issue 1, p79
- ISSN
0300-0664
- Publication type
Article
- DOI
10.1111/j.1365-2265.2004.02177.x