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Type: Journal article
Title: Determinants of maternal triglycerides in women with gestational diabetes mellitus in the Metformin in Gestational Diabetes (MiG) study
Author: Barrett, H.
Nitert, M.
Jones, L.
O'Rourke, P.
Lust, K.
Gatford, K.
De Blasio, M.
Coat, S.
Owens, J.
Hague, W.
McIntyre, H.
Callaway, L.
Rowan, J.
Citation: Diabetes Care, 2013; 36(7):1941-1946
Publisher: Amer Diabetes Assoc
Issue Date: 2013
ISSN: 0149-5992
Statement of
Helen L. Barrett, Marloes Dekker Nitert, Lee Jones, Peter O’Rourke, Karin Lust, Kathryn L. Gatford, Miles J. De Blasio, Suzette Coat, Julie A. Owens, William M. Hague, H. David McIntyre, Leonie Callaway, and Janet Rowan
Abstract: OBJECTIVE Factors associated with increasing maternal triglyceride concentrations in late pregnancy include gestational age, obesity, preeclampsia, and altered glucose metabolism. In a subgroup of women in the Metformin in Gestational Diabetes (MiG) trial, maternal plasma triglycerides increased more between enrollment (30 weeks) and 36 weeks in those treated with metformin compared with insulin. The aim of this study was to explain this finding by examining factors potentially related to triglycerides in these women. RESEARCH DESIGN AND METHODS Of the 733 women randomized to metformin or insulin in the MiG trial, 432 (219 metformin and 213 insulin) had fasting plasma triglycerides measured at enrollment and at 36 weeks. Factors associated with maternal triglycerides were assessed using general linear modeling. RESULTS Mean plasma triglyceride concentrations were 2.43 (95% CI 2.35–2.51) mmol/L at enrollment. Triglycerides were higher at 36 weeks in women randomized to metformin (2.94 [2.80–3.08] mmol/L; +23.13% [18.72–27.53%]) than insulin (2.65 [2.54–2.77] mmol/L, P = 0.002; +14.36% [10.91–17.82%], P = 0.002). At 36 weeks, triglycerides were associated with HbA1c (P = 0.03), ethnicity (P = 0.001), and treatment allocation (P = 0.005). In insulin-treated women, 36-week triglycerides were associated with 36-week HbA1c (P = 0.02), and in metformin-treated women, they were related to ethnicity. CONCLUSIONS At 36 weeks, maternal triglycerides were related to glucose control in women treated with insulin and ethnicity in women treated with metformin. Whether there are ethnicity-related dietary changes or differences in metformin response that alter the relationship between glucose control and triglycerides requires further study.
Keywords: Humans
Diabetes, Gestational
Hypoglycemic Agents
Rights: © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details.
DOI: 10.2337/dc12-2132
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Obstetrics and Gynaecology publications

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