NEW PUBLICATION Gestational Diabetes in Oslo is much more common than previously thought.

553 pregnant Scandinavian women (STORK study) underwent 75g oral glucose Tolerance Test at week 14-16 and 30-32. Eleven women (2,1%) had gestational diabetes (GDM1) (WHO criteria) at week 14-16, and 49 (9,4%) at week 30-32 (GDM2), which is higher than previously reported in this region. In the subdivision of OGTT more overweight (BMI > 25) was found in glucose intolerant groups (glucose tolerant women (NGT) 38% vs. GDM2 58% and GDM1 82%, p<0,005). In early pregnancy insulin sensitivity was lowest in GDM1, intermediate in GDM2 .insulin sensitivity decreased in all groups, most in gestational diabetes. Beta-cell function demonstrated minor shifts during pregnancy, but when adjusted for decreasing insulin sensitivity, Dio(oral disposition index ) levels fell by 40 % (p<0,001). DIo was significantly attenuated relative to glucose intolerance (GDM1 25%, GDM2 53%) during pregnancy. In overweight women, DIo levels were lower throughout pregnancy (p<0,001 vs normal weight women), this reduction was significant (p<0,01) in both NGT (21-25%) and GDM2 subjects (26-49%). Conclusion: Beta-cell function adjusted for insulin sensitivity (DIo) deteriorated during pregnancy in both glucose tolerant and glucose intolerant women. The failure to compensate the decrease in insulin sensitivity was accentuated in overweight women.

Consequences: Gestational diabetes occurs in about 10 % of ethnic norwegians. This is far higher than previously thought (1-2 %).This is at least partly due to increasing adioposy in fertile norwegian women. This mustl have profound influence on how we organize care for pregnant women in Norway in the future.

Qvigstad E, Voldner N, Godang K, Henriksen T, Bollerslev J.Overweight is associated with impaired beta-cell function during pregnancy: A longitudinal study of 553 normal pregnancies. Eur J Endocrinol. 2009 Oct 19. [Epub ahead of print]