Vol 10, No 3 (2021)
Research paper
Published online: 2021-03-03

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Body mass index correlates positively with insulin resistance and secretion but inversely with insulin sensitivity in gestational diabetes

Tania Tofail1, Sharmin Jahan1, Mashfiqul Hasan2, Fakhrul Alam3, Mohammad Fariduddin14, Ahmed Abu Saleh14, Muhammad Abul Hasanat1
Clin Diabetol 2021;10(3):270-275.

Abstract

Background. To assess fasting C-peptide and insulin
indices using homeostatic model assessment (HOMA)
in gestational diabetes mellitus (GDM).
Methods. Gestational diabetes mellitus (n = 64, age:
27.02 ± 0.53 years, BMI: 26.3 ± 0.5 kg/m2; mean ±
SEM) and normal glucose tolerance NGT (n = 56, age:
26.11 ± 0.55 years, BMI: 24.4 ± 0.4 kg/m2; mean ±
SEM) screened according to WHO 2013 criteria. Glucose
was measured by oxidase method whereas fasting
insulin and C-peptide by ELISA. HOMA-IR, HOMA-B and
HOMA-%S were calculated.

Results. C-peptide was found higher in GDM compared
to NGT without any significant difference (P = 0.465).
Fasting insulin (P = 0.063) and HOMA-IR (P < 0.001)
were significantly higher while HOMA-B (P = 0.015)
and HOMA-%S (P = 0.012) were significantly lower in
GDM than those of NGT. BMI, bad obstetric history,
multiparity and blood glucose were higher (P ≤ 0.05)
in GDM while age, duration of gestation, family history
of DM did not differ (P = NS). C-peptide (0.185 ± 0.06
vs 0.331 ± 0.44; P < 0.05), fasting insulin (4.88 ± 0.74
vs 10.37 ± 0.74; P < 0.01) and HOMA-IR (1.04 ± 0.14 vs
2.48 ± 0.18; P < 0.011) as well as HOMA-B were found
lower in GDM having BMI < 23 kg/m2 than those of
GDM with BMI ≥ 23. Conversely, HOMA-%S (115.52 ±
14.63 vs 50.62 ± 3.39; P < 0.011) was higher in the
subgroup with BMI < 23 than the rest. Fasting blood
glucose (FBG) (P < 0.01) and fasting insulin (P < 0.05)
were independent predictors for GDM.

Conclusions. Fasting C-peptide did not differ between
GDM and NGT. BMI was positively related with resistance
and secretion of insulin but inversely with sensitivity.
HOMA model analyses revealed decreased insulin
sensitivity and secretory capacity in GDM than NGT.

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