Clinical assessment of insulin action during late pregnancy in women at risk for gestational diabetes: Association of maternal glycemia with perinatal outcome

Insulin sensitivity index [SI_OGTT] values derived from the OGTT (A); corrected insulin response at glucose peak [CIR_gp] (B); and insulin secretion-sensitivity index [IS-SI] (C) stratified by race and glucose tolerance group. The mean SI_OGTT values progressively decreased from GDM to GIGT to NGT-abGCT (A). Findings further illustrate that GDM is characterized by impairment of pancreatic β-cell function (CIR_gp) with a progressive reduction going from women with NGT to those with GIGT and GDM status (B). In all glucose tolerance groups, AA women had greater insulin secretory responses than Cau. The worsening glycemic profile is reflected in the trend of decreasing mean IS-SI score from NGT-abnGCT to IGT to GDM (C). The IS-SI was higher in AA women with NGT compared with Cau, no impact of race on IS-SI was seen in women with GIGT and GDM.