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Diabetes Care. 2014 Dec;37(12):3294-300. doi: 10.2337/dc14-1433.

High calorie intake is associated with worsening insulin resistance and β-cell function in Hispanic women after gestational diabetes mellitus.

Author information

1
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
2
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Physiology and Biophysics, University of Southern California, Los Angeles, CA Diabetes & Obesity Research Institute, University of Southern California, Los Angeles, CA.
3
Diabetes & Obesity Research Institute, University of Southern California, Los Angeles, CA Department of Medicine, Division of Diabetes and Endocrinology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
4
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA anny.h.xiang@kp.org.

Abstract

OBJECTIVE:

To assess associations between dietary intake and rates of change in insulin resistance and β-cell function in Hispanic women with prior gestational diabetes mellitus (GDM).

RESEARCH DESIGN AND METHODS:

Sixty-two nondiabetic Hispanic women with pregnancies complicated by GDM completed oral and intravenous glucose tolerance tests and bioelectrical impedance measurements of body fat every 12-15 months postpartum for up to 12 years. Self-reported dietary intake was collected at all visits by structured food frequency questionnaires developed for Hispanics. Mixed-effects models were used to assess the relationship between dietary intake and rates of change in metabolic outcomes during follow-up.

RESULTS:

The median length of follow-up from the first postpartum evaluation was 8.0 years (interquartile range 4.5-10.8 years). At baseline, women were 32 ± 5.7 years old and had a median calorie intake of 2,091 kcal/day. Over the course of follow-up, dietary intake did not change significantly. Higher baseline calorie intake was associated with a faster decline in insulin sensitivity, measured by the insulin sensitivity index (SI) (P = 0.029), and β-cell compensation, measured by the disposition index (DI) (P = 0.027), over time. These associations remained after adjustment for baseline characteristics; changes in BMI, calorie intake, levels of physical activity; and additional pregnancies during the follow-up period. The median rates were -0.06 vs. -0.02 units/year for SI and -810 vs. -692 units/year for DI for women with baseline calorie intake above versus below the cohort median.

CONCLUSIONS:

High calorie intake is associated with a faster decline in insulin sensitivity and β-cell compensation in Hispanic women who are at high risk for type 2 diabetes, independent of adiposity.

PMID:
25404660
PMCID:
PMC4237976
DOI:
10.2337/dc14-1433
[Indexed for MEDLINE]
Free PMC Article

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