Abstract

We prospectively evaluated differences in fasting- and oral glucose tolerance test (OGTT)-derived indices of insulin action in Caucasian and African-American pregnant women and compared them with obstetric outcomes. Pregnancy is a diabetogenic condition characterized by insulin resistance with a compensatory increase in β-cell response and hyperinsulinemia. Normal women compensate for insulin resistance by increasing insulin secretion to maintain normal glucose tolerance, pregnancy, occurs when insulin secretion is insufficient to compensate for the insulin resistance of pregnancy. Women with GDM have a limited ability to increase their insulin secretion. They have very blunt glucose-stimulated insulin responses compared with the augmented insulin responses of normal pregnant women.