Continuous Glucose Profiles in Obese and Normal-Weight Pregnant Women on a Controlled Diet
Open Access
- 15 September 2011
- journal article
- clinical trial
- Published by American Diabetes Association in Diabetes Care
- Vol. 34 (10), 2198-2204
- https://doi.org/10.2337/dc11-0723
Abstract
OBJECTIVE: We sought to define 24-h glycemia in normal-weight and obese pregnant women using continuous glucose monitoring (CGM) while they consumed a habitual and controlled diet both early and late in pregnancy. RESEARCH DESIGN AND METHODS: Glycemia was prospectively measured in early (15.7 ± 2.0 weeks’ gestation) and late (27.7 ± 1.7 weeks’ gestation) pregnancy in normal-weight (n = 22) and obese (n = 16) pregnant women on an ad libitum and controlled diet. Fasting glucose, triglycerides (early pregnancy only), nonesterified fatty acids (FFAs), and insulin also were measured. RESULTS: The 24-h glucose area under the curve was higher in obese women than in normal-weight women both early and late in pregnancy despite controlled diets. Nearly all fasting and postprandial glycemic parameters were higher in the obese women later in pregnancy, as were fasting insulin, triglycerides, and FFAs. Infants born to obese mothers had greater adiposity. Maternal BMI (r = 0.54, P = 0.01), late average daytime glucose (r = 0.48, P < 0.05), and late fasting insulin (r = 0.49, P < 0.05) correlated with infant percentage body fat. However, early fasting triglycerides (r = 0.67, P < 0.001) and late fasting FFAs (r = 0.54, P < 0.01) were even stronger correlates. CONCLUSIONS: This is the first study to demonstrate that obese women without diabetes have higher daytime and nocturnal glucose profiles than normal-weight women despite a controlled diet both early and late in gestation. Body fat in infants, not birth weight, was related to maternal BMI, glucose, insulin, and FFAs, but triglycerides were the strongest predictor. These metabolic findings may explain higher rates of infant macrosomia in obese women, which might be targeted in trials to prevent excess fetal growth.Keywords
This publication has 17 references indexed in Scilit:
- Hyperglycemia and Adverse Pregnancy OutcomesThe New England Journal of Medicine, 2008
- Summary and Recommendations of the Fifth International Workshop-Conference on Gestational Diabetes MellitusDiabetes Care, 2007
- Management of Obesity in PregnancyObstetrics & Gynecology, 2007
- Prevalence of Overweight and Obesity in the United States, 1999-2004JAMA, 2006
- ACOG Committee Opinion #315: Obesity in PregnancyObstetrics & Gynecology, 2005
- Body fat measurement in adolescents: comparison of skinfold thickness equations with dual-energy X-ray absorptiometryEuropean Journal of Clinical Nutrition, 2005
- Body fat in neonates and young infants: validation of skinfold thickness versus dual-energy X-ray absorptiometry,,The American Journal of Clinical Nutrition, 2002
- Longitudinal assessment of energy balance in well-nourished, pregnant womenThe American Journal of Clinical Nutrition, 1999
- Percentage of Carbohydrate and glycemic Response to Breakfast, Lunch, and Dinner in Women With Gestational DiabetesDiabetes, 1991
- Skinfold equations for estimation of body fatness in children and youth.1988