Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Acta Medica Bulgarica

2 Issues per year

Open Access
See all formats and pricing
More options …

Assessment of Beta-Cell Function During Pregnancy and after Delivery

M. P. Genova
  • Corresponding author
  • Department of Clinical Laboratory and Clinical Immunology, Medical University, University Hospital “Alexandrovska”, Sofi a, Bulgaria
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ K. Todorova-Ananieva / B. Atanasova
  • Department of Clinical Laboratory and Clinical Immunology, Medical University, University Hospital “Alexandrovska”, Sofia, Bulgaria
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ K. Tzatchev
  • Department of Clinical Laboratory and Clinical Immunology, Medical University, University Hospital “Alexandrovska”, Sofi a, Bulgaria
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2014-11-05 | DOI: https://doi.org/10.2478/amb-2014-0001


The aim of the present study was to assess β-cell function using homeostasis model (HOMA-B) and disposition index (DI) in pregnant women with/without gestational diabetes, and after delivery. A total of 102 pregnant women between 24-28 gestational weeks (53 with gestational diabetes mellitus (GDM) and 49 with normal glucose tolerance (NGT) and 22 GDM postpartum women (8-12 weeks after delivery) were included in the study. All postpartum women had a history of GDM. HOMA indexes (insulin resistance - HOMA-IR and HOMA-B for assessing β-cell function) were calculated from fasting glucose and insulin concentrations. To estimate insulin secretion independent of insulin sensitivity, DI was calculated using glucose and insulin levels at 0 and 60 min during the course of a 2 h 75g oral glucose tolerance test (OGTT). In GDM pregnant women HOMA-B was significantly lower compared to NGT women (p = 0.017), but there was no significant difference compared to women after birth (NS). There was difference between NGT and postpartum women (p < 0.05). DI was significantly lower for GDM pregnant women in comparison to NGT and postpartum women (p < 0.0001; p = 0.011), between NGT and women after birth (p < 0.04). In our study, comparison of НОМА-В in NGT and GDM pregnant women demonstrated that the OR of developing GDM was 0.989 (95% CI, 0.980-0.998, P = 0.013), and comparison of DI in healthy pregnant and GDM showed that the OR of developing GDM was 0.967 (95% CI, 0.947-0.988, P = 0.002). Therefore, HOMA-B and DI appear to be protective factors in the risk of developing GDM. According to our results, assessment of β-cell function, using HOMA-B and DI, showed that they are lower in GDM than NGT group and postpartum women. It is important to note that HOMA-B did not show significant difference between GDM pregnant and women after delivery with a history for GDM. We assume that pregnant women with GDM have a pancreatic β-cell defect that remains after birth. These women are at increased risk for developing diabetes mellitus, the most frequent type 2 diabetes, in the future after birth.

Keywords : gestational diabetes mellitus; β-cell function; homeostasis model assessment; disposition index


  • 1. Barbour, L. A. et al. Cellular mechanisms for insulin resistance in normal pregnancy and gestational diabetes. - Diabetes Care, 30, 2007, (Suppl. 2), S112-S119.CrossrefWeb of ScienceGoogle Scholar

  • 2. Basu , R. et al. Mechanisms of age-associated determination in glucose tolerance, contribution of alterations in insulin secretion, action and clearance. - Diabetes, 52, 2003, 1738-1748.PubMedGoogle Scholar

  • 3. Bergman , R. N., L. S. Phillips et C. Cobelli. Physiologic evaluation of factors controlling glucose tolerance in man: measurement of insulin sensitivity and β-cell glucose sensitivity from the response to intravenous glucose. - J. Clin. Invest., 68, 1981, № 68, 1456-1467.Google Scholar

  • 4. Buchanan , T. A. Pancreatic Β-cell defects in gestational diabetes: implications for the pathogenesis and prevention of type 2 diabetes. - J. Clin. Endocrinol. Metab., 86, 2001, 989-993. Google Scholar

  • 5. Buchanan , T. A. et A. H. Xiang. Gestational diabetes mellitus. - J. Clin. Invest., 115, 2005, 485-491.Google Scholar

  • 6. Buchanan , А. T., A. H. Xiang, L. K. Siri et R. Watanabe. What is gestational diabetes? - Diabetes Care., 30, 2007, № 2, 105-111.Google Scholar

  • 7. Buchanan , T. A. et al. Preservation of pancreatic β-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk Hispanic women. - Diabetes, 51, 2002, 2796-2803.PubMedGoogle Scholar

  • 8. Catalano , P. M. et al. Longitudinal changes in glucose metabolism during pregnancy in obese women with normal glucose tolerance and gestational diabetes mellitus. - Am. J. Obstet. Gynecol., 180, 1999, 903-916.Google Scholar

  • 9. Cobelli , C. et al. Assessment of β-cell function in humans, simultaneously with insulin sensitivity and hepatic extraction, from intravenous and oral glucose tests. - Am. J. Physiol. Endocrinol. Metab., 293, 2007, E1-E15.Web of ScienceGoogle Scholar

  • 10. Das , S. M., S. Misra et A. Baliarsihna. Beta-cell function and insulin resistance in pregnancy and their relation to fetal development. - Metab. Syndr. Relat. Disord., 8, 2010, № 1, 25-32.Web of ScienceGoogle Scholar

  • 11. Endo , S. et al. Differences in insulin sensitivity in pregnant women with overweight and gestational diabetes mellitus. - Gynecological Endocrinology, 22, 2006, № 6, 343-349.Google Scholar

  • 12. Ernst , S. et al. Mechanisms in the adaptation of maternal β-cells during pregnancy. - Diabetes Management, 1, 2011, 239-248.CrossrefGoogle Scholar

  • 13. Homko , C. et al. Guenther. Insulin secretion during and after pregnancy in patients with gestational diabetes mellitus. - J. Clin. Endocrinol. Metab., 86, 2001, 568-573.Google Scholar

  • 14. International Association of Diabetes and Pregnancy Study Groups Consensus Panel 2010. - Diabetes Care, 33, 2010, № 3, 676-682.Web of ScienceGoogle Scholar

  • 15. Kahn , S. E. Clinical review 135: the importance of β-cell failure in the development and progression of type 2 diabetes. - J. Clin. Endocrinol. Metab., 86, 2001, 4047-4058.Google Scholar

  • 16. Kahn , S. E. The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes. - Diabetologia, 46, 2003, 3-19.PubMedGoogle Scholar

  • 17. Kahn , S. E. et al. Quantifi cation of the relationship between insulin sensitivity and Β-cell function in human subjects: evidence for a hyperbolic function. - Diabetes, 42, 1993, 1663-1672.Google Scholar

  • 18. Matthews , D. R, J. P Hosker et A. S Rudenski. Homeostasis model assessment: insulin resistance and beta cell function from fasting plasma glucose and insulin concentrations in man. - Diabetologia, 28, 1985, 412-419.CrossrefPubMedGoogle Scholar

  • 19. Metzger, B. E. et D. R. Coustan. Summary and recommendations of the Fourth International Workshop Conference on Gestational Diabetes Mellitus. - Diabetes Care, 21, 1998, (Suppl. 2), B161-B167.Web of ScienceGoogle Scholar

  • 20. Miyakoshi , K. et al. Pancreatic β-cell Function in Women With Gestational Diabetes Mellitus Defi ned by New Consensus Criteria. - Diabetes Care, 34, 2011, 1-8.Google Scholar

  • 21. Mørkrid , K. et al. Failure to increase insulin secretory capacity during pregnancy-induced insulin resistance is associated with ethnicity and gestational diabetes. - Eur. J. Endocrinol., 167, 2012, 579-588.Google Scholar

  • 22. Phillips , D. I., P. M. Clark, C. N. Hales et C. Osmond. Understanding oral glucose tolerance: comparison of glucose or insulin measurements during the oral glucose tolerance test with specific measurements of insulin resistance and insulin secretion. - Diabet. Med., 11, 1994, 286-292.CrossrefGoogle Scholar

  • 23. Qvigstad , E. et al. Overweight is associated with impaired β-cell function during pregnancy: a longitudinal study of 553 normal pregnancies. - Eur. J. Endocrinol., 162, 2010, 67-73.Web of ScienceGoogle Scholar

  • 24. Ryan , E. A. et al. Defects in insulin secretion and action in women with a history of gestational diabetes. - Diabetes, 44, 1995, 506 -512. PubMedGoogle Scholar

  • 25. Ryan , E. A., M. J. O’Sullivan et J. Skyler. Insulin action during pregnancy. Studies with the euglycemic clamp technique. - Diabetes, 34, 1985, 380-389.CrossrefPubMedGoogle Scholar

  • 26. Utzschneider, K. et al. Oral Disposition Index Predicts the Development of Future Diabetes Above and Beyond Fasting and 2-h Glucose Levels. - Diabetes Care, 32, 2009, № 2, 335-341.Google Scholar

  • 27. Xiang, A. H. et al. Coordinate changes in plasma glucose and pancreatic β-cell function in Latino women at high risk for type 2 diabetes. - Diabetes, 55, 2006, 1074-1079. Google Scholar

About the article

Published Online: 2014-11-05

Published in Print: 2014-06-01

Citation Information: Acta Medica Bulgarica, Volume 41, Issue 1, Pages 5–12, ISSN (Online) 0324-1750, DOI: https://doi.org/10.2478/amb-2014-0001.

Export Citation

© 2014. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. BY-NC-ND 3.0

Comments (0)

Please log in or register to comment.
Log in