ECE2023 Eposter Presentations Late Breaking (91 abstracts)
Subtypes of gestational diabetes based on indices of insulin sensitivity and insulin secretion
Andrea Fernández Valero 1 , Teresa María Linares Pineda 1 , Fuensanta Lima Rubio 1 , Maria Molina Vega 1 , Carolina Gutierrez Repiso 1 , Nerea Peña Montero 1 , María Suárez Arana 2 , Ana María Fernández Ramos 1 , Francisco J Tinahones 1 , María José Picón César 1 & Sonsoles Morcilo 1
1Hospital Virgen de la Victoria, Endocrinology and Nutrition, Málaga, Spain, 2Hospital Regional Universitario de Málaga, Ginecology and Obstetrics, Málaga, Spain
Objectives: Some authors have defined subtypes within gestational diabetes (GD) based on the calculation, from glucose and insulin levels during oral glucose overload (OGTT), of indices of insulin sensitivity (Matsuda) and insulin secretion (Stumvoll). Powe et al [1] found that 30% of women with GD had predominantly low insulin secretion, 51% low insulin sensitivity and 18% both (mixed). The aim of this work is to analyze the correlation of these indices with other known parameters of insulin sensitivity and insulin secretion and the definition of GD subtypes in our population.
Material and Methods: We calculated the Matsuda and Stumvoll indices (at 120 minutes), from the data of 68 100 g OGTT for the diagnosis of GD (both basal, 1-hour, 2-hour and 3-hour glucose and insulin were determined) and correlated them with HOMA and C-peptide. Based on the 25th percentile of these indices in the non-GD population, we established cut-off points and defined the 29 GD patients as having predominantly low insulin sensitivity (Matsuda<25th percentile), predominantly low insulin secretion (Stumvoll<25th percentile), both, or neither.
Results: We found that both the Matsuda and Stumvoll indices correlated significantly inversely with HOMA and C-peptide, as well as with each other directly, both in the general population and in women with GD (Table 1).
| General population | HOMA | C-peptide | Stumvoll |
| Matsuda | r= -0.635 (P< 0.001) | r= -0.674 (P< 0.001) | r= 0.308 (P=0.011) |
| Stumvoll | r= -0.504 (P< 0.001) | r= -0.361 (P=0.003) | |
| GD | HOMA | Péptido C | Stumvoll |
| Matsuda | r= -0.689 (P< 0.001) | r= -0.793 (P< 0.001) | r= 0.472 (P=0.010) |
| Stumvoll | r= -0.544 (P=0.002) | r= -0.382 (P=0.041) |
Conclusion: Both the Stumvoll index and, mainly, the Matsuda index correlate well with HOMA, which is more widely used and easier to calculate. Contrary to that previously described by Powe et al [1], in our population the mixed GD group predominates, with a similar percentage of women with a predominance of low insulin secretion and a much lower percentage with a predominance of low insulin sensitivity.1. Powe CE, Allard C, Battista MC, Doyon M, Bouchard L, Ecker JL, Perron P, Florez JC, Thadhani R, Hivert MF. Heterogeneous Contribution of Insulin Sensitivity and Secretion Defects to Gestational Diabetes Mellitus. Diabetes Care. 2016 Jun;39(6):1052-5. doi:10.2337/dc15-2672.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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