Two-hour insulinemia after oral glucose overload and women at risk of pregnancy-induced hypertensive disorders

Abstract

Objective: Pregnant women with impaired insulin sensitivity are at risk for developing pregnancy-induced hypertensive disorders (PIHD). We analyzed glucose and insulin circulating levels throughout a 2-h oral 75 g glucose tolerance test in pregnant women, and related the 2-h insulinemias to PIHD prevalence. Methods: Pregnant women (gestational week 24–28) were submitted to a glucose overload, and glucose and insulin plasma concentrations were measured throughout the test. These peripheral metabolite levels, the homeostasis model assessment (HOMA) values and the glucose to insulin ratio (G:Ir) were analyzed. Anthropometric parameters and pregnancy outcome were recorded. Results: Women with normal fasting glycemia, insulinemia and HOMA values, G:Ir and 2 h-glycemia but whose 2 h-insulinemia was higher than 215.25 pM were at greater risk for developing late pregnancy hypertension and preeclampsia compared to women of similar characteristics but whose 2 h-insulinemias were lower than 215.25 pM. Conclusion: 2-h insulinemias higher than 215.25 pM after a 75 g glucose overload could be highly indicative of women at increased risk of developing PIHD.

• Glucose:insulin ratio
• Gestational diabetes mellitus
• Gestational hypertension
• HOMA
• Preeclampsia
• Pregnancy outcome.

Acknowledgements

Authors wish to thank Mrs. S. H. Rogers and A. Di Maggio for careful edition and correction of the manuscript. Authors are also indebted to Dr. J. Lopez-Camelo for his valuable advice on statistical analyses. The technical assistance by Mrs. C. Pasciuco and Miss. A. Prospitti is also recognized.