Endocrine Abstracts

Objective: To study the GLP-1 pattern of secretion after an oral glucose tolerance test (OGTT) in women in postpartum reassessment of previous gestational diabetes (GDM). To evaluate clinical and laboratory parameters that can influence GLP-1 secretion.

Patients and methods: Forty-eight women with a history of GDM were assessed one year after childbirth determining clinical and analytical characteristics and OGTT with 75 g. We measured glucose, insulin and GLP-1 (baseline, 30′, 60′, 120′). Women were classified according to the results of OGTT as healthy and prediabetic/diabetic patients.

Results: Patients mean age of 35±5 years, BMI 29±6 kg/m², SBP 117±12 mmHg, DBP 77±9 mmHg. Laboratory parameters: glucose 99±16 mg/dl, insulin 9±5 microU/ml, cholesterol 167±31 mg/dl, HDL-c 48±12 mg/dl, LDL-c 100±23 mg/dl, triglycerides 95±48 mg/dl, HbA1c 5.5±0.38%. In postpartum analysis, 23 had normal reassessment and 25 pathological OGTT. There were no significant differences in levels of GLP-1 in both groups. GLP-1 AUC/AUC insulin (r=−0.28, P=0.05) increase GLP; AUC correlations between GLP-1/age (P=0.05, r=0.28) were observed 1/AUC insulin (r=−0.38, P=0.01) and numerical correlation between increased GLP-1/c-HDL (r=−0.26; P=0.07) and increase GLP-1/BMI (r=−0.23; P=0.12). The linear regression model showed insulin AUC (r²=0.1, P=0.04) as predictor of GLP-1 AUC, and BMI (P=0,00), triglycerides (P=0.01) and c-HDL (P=0.01) and AUC insulin (P=0.02) as predictors of increased GLP-1 (r²=0.5).

Conclusions: Women with GDM history and prediabetes/diabetes diagnosis in postpartum reassessment do not differ in GLP-1 secretion after OGTT compared to healthy subjects. The parameters related to GLP-1 response in postpartum OGTT are BMI, triglycerides, HDL-C and insulin AUC.