ArticleThe Journal of clinical endocrinology and metabolism2025
Heterogeneity of Gestational Diabetes and Risk for Adverse Pregnancy Outcome: A Cohort Study.
Article in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Perinatal and long-term implications of diagnosing gestational diabetes mellitus using only fasting and one-hour post-load glucose concentrations: Secondary analysis of the GEMS trial and its five-year follow-up.Acta obstetricia et gynecologica Scandinavica · 2026Trial
- Second trimester serum lipidomics predicts large-for-gestational-age infants in apparently metabolically healthy pregnancies.iScience · 2026Article
- Observational
- Article
- From Molecular Insights to Clinical Management of Gestational Diabetes Mellitus-A Narrative Review.International journal of molecular sciences · 2025Review
- Dynamic OGTT-derived C-peptide trajectories for metabolic heterogeneity and adverse pregnancy outcomes in gestational diabetes mellitus: a nested case‒control study.BMC medicine · 2025Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
contextDiabetes is increasingly recognized as a heterogeneous disease, with clinical characteristics and outcome risks varying across different phenotypes. Evidence on heterogeneity of gestational diabetes (GDM) is yet to be provided.
objectiveTo investigate the insulin physiology and pregnancy outcomes of GDM phenotypes characterized by fasting hyperglycemia or postload hyperglycemia.
methodsA total of 2050 women who underwent a 75-g oral glucose tolerance test were prospectively recruited and followed until delivery. Women were categorized into normoglycemia (NGT, n = 936), isolated impaired fasting glucose (gestational-IFG, n = 378), and isolated impaired postload glucose tolerance (gestational-IGT, n = 736) groups. Fasting blood samples at mid-pregnancy were collected to measure C-peptide and insulin concentrations. Homeostasis model assessment (HOMA) and quantitative insulin sensitivity check index (QUICKI) were used to evaluate insulin physiology. Maternal and neonatal outcomes were recorded.
resultsGestational-IFG had greater insulin resistance (HOMA-IR 3.11 vs 2.25, QUICKI-C-peptide 0.94 vs 1.03, both P < .01), and gestational-IGT had worse β-cell function (C-peptide 2.00 vs 2.26 ng/mL, P < .05), when compared to one another. Gestational-IFG was more strongly associated with excessive gestational weight gain (risk ratio [RR] 1.62; 95% CI, 1.18-2.23) and large-for-gestational-age infants (RR 1.45; 95% CI, 1.03-2.03) than gestational-IGT. The risk for neonatal brain injury was increased in gestational-IGT (RR 2.03; 95% CI, 1.04-4.09), but not in gestational-IFG (P = .439). Gestational-IGT showed a stronger association with the risk of preterm birth compared to gestational-IFG (RR 1.80; 95% CI, 1.02-3.36).
conclusionGDM exhibits distinct insulin physiology profiles. Pregnancy outcome varies between each phenotype. These findings provide evidence on risk stratification and diverse strategies for the treatment of GDM.
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