科研之友
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摘要
Aims Women with gestational diabetes are at high risk for developing diabetes; post-partum weight loss may reduce the risk of diabetes. We evaluated the association of post-partum weight change with changes in glucose, insulin and homeostasis model assessment of insulin resistance in a subsample (n=72) of participants from Diet Exercise and Breastfeeding Intervention (DEBI), a randomized pilot trial of lifestyle intervention for women with gestational diabetes. Methods Glucose and insulin were measured fasting and 2h after an oral glucose tolerance test at 6weeks and 12months post-partum. Women were categorized by weight change (lost >2kg vs. maintained/gained) between 6weeks and 12months post-partum. Results Compared with women who maintained or gained weight, women who lost >2kg experienced significantly lower increases in fasting glucose [age-adjusted means: 0.1mmol/l (95%CI -0.03 to 0.3) vs. 0.4mmol/l (95%CI 0.3-0.6); P<0.01] and 2-h insulin [10.0pmol/l (95%CI -56.9 to 76.9) vs. 181.2pmol/l (95%CI 108.3-506.9); P<0.01] and a significant reduction in 2-h glucose [-0.9mmol/l (95%CI -1.4 to -0.3) vs. 0.3mmol/l (95%CI -0.3 to 0.9); P<0.01]. In multiple linear regression models adjusted for age, Hispanic ethnicity, medication use, meeting the Institute of Medicine's recommendations for gestational weight gain, breastfeeding and randomized group, a 1-kg increase in weight was significantly associated with increases in fasting and 2-h glucose (P<0.05), but was not associated with insulin or homeostasis model assessment of insulin resistance. Conclusions In women with gestational diabetes, modest post-partum weight loss may be associated with improvements in glucose metabolism.
- 出版日期2014-7
