{"doi":"10.2337/dc22-1894","title":"Insulin Sensitivity and β-Cell Function During Early and Late Pregnancy in Women With and Without Gestational Diabetes Mellitus","abstract":"OBJECTIVE: To evaluate the metabolic alterations associated with gestational diabetes mellitus (GDM) in women with overweight or obesity. RESEARCH DESIGN AND METHODS: We compared fasting and postprandial plasma glucose and free fatty acid (FFA) concentrations, insulin sensitivity (IS; Matsuda index), and β-cell function (i.e., β-cell responsiveness to glucose) by using a frequently sampled oral glucose tolerance test (OGTT) at 15 and 35 weeks' gestation in women with overweight or obesity who had GDM (n = 29) or did not have GDM (No-GDM; n = 164) at 35 weeks. RESULTS: At 15 weeks, IS and β-cell function were lower, and fasting, 1-h, and total area-under-the-curve plasma glucose concentrations during the OGTT were higher (all P < 0.05) in the GDM than in the No-GDM group. At 35 weeks compared with 15 weeks, IS decreased, β-cell function increased, and postprandial suppression of plasma FFA was blunted in both the GDM and No-GDM groups, but the decrease in IS and the increase in postprandial FFA concentration were greater and the increase in β-cell function was less (all P ≤ 0.05) in the GDM than in the No-GDM group. A receiver operating characteristic curve analysis showed that both fasting plasma glucose and 1-h OGTT glucose concentration at 15 weeks are predictors of GDM, but the predictive power was <30%. CONCLUSIONS: Women with overweight or obesity and GDM, compared with those without GDM, have worse IS and β-cell function early during pregnancy and a greater subsequent decline in IS and blunted increase in β-cell function. Increased fasting and 1-h OGTT plasma glucose concentration early during pregnancy are markers of increased GDM risk, albeit with weak predictive power.","journal":"Diabetes Care","year":2023,"id":333317,"datarank":0.8942518883609001,"base_score":3.1780538303479458,"endowment":3.1780538303479458,"self_citation_contribution":0.47670807455219194,"citation_network_contribution":0.4175438138087081,"self_endowment_contribution":0.47670807455219194,"citer_contribution":0.4175438138087081,"corpus_percentile":null,"corpus_rank":null,"citation_count":23,"citer_count":23,"citers_with_citation_signal":15,"citers_with_endowment":15,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9432,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT01768793"],"figshare":["10.2337/figshare.22816130"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":240817,"name":"Bruce W. Patterson","orcid":"0000-0001-9261-0233","position":1,"is_corresponding":false},{"id":332606,"name":"Debra Haire‐Joshu","orcid":"0000-0001-6255-5616","position":2,"is_corresponding":false},{"id":257467,"name":"Alison G. Cahill","orcid":"0000-0002-6012-3374","position":3,"is_corresponding":false},{"id":345703,"name":"W. Todd Cade","orcid":"0000-0002-2329-7623","position":4,"is_corresponding":false},{"id":240813,"name":"Richard I. Stein","orcid":"0000-0003-1614-4845","position":5,"is_corresponding":false},{"id":55892,"name":"Samuel Klein","orcid":"0000-0001-7127-1156","position":6,"is_corresponding":false},{"id":304278,"name":"Bettina Mittendorfer","orcid":"0000-0003-0049-2677","position":0,"is_corresponding":true}],"reference_count":47,"raw_metadata":null,"created_at":"2026-07-19T01:09:39.719497Z","pmid":"37262059","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}