Effect of excessive gestational weight gain on insulin sensitivity and insulin kinetics in women with overweight/obesity

William Todd Cade, Bettina Mittendorfer, Bruce W. Patterson, Debra Haire-Joshu, Alison G. Cahill, Richard I. Stein, Kenneth B. Schechtman, Rachel A. Tinius, Katherine Brown, Samuel Klein

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective: Obesity increases the risk for pregnancy complications and maternal hyperglycemia. The Institute of Medicine developed guidelines for gestational weight gain (GWG) targets for women with overweight/obesity, but it is unclear whether exceeding these targets has adverse effects on maternal glucose metabolism. Methods: Insulin sensitivity (assessed using the Matsuda Insulin Sensitivity Index), β-cell function (assessed as insulin secretion rate in relation to plasma glucose), and plasma insulin clearance rate were evaluated using a frequently sampled oral glucose tolerance test at 15 and 35 weeks of gestation in 184 socioeconomically disadvantaged African American women with overweight/obesity. Results: Insulin sensitivity decreased, whereas β-cell function and insulin clearance increased from 15 to 35 weeks of gestation in the entire group. Compared with women who achieved the recommended GWG, excessive GWG was associated with a greater decrease in insulin sensitivity between 15 and 35 weeks. β-cell function and plasma insulin clearance were not affected by excessive GWG. Conclusions: These data demonstrate that gaining more weight during pregnancy than recommended by the Institute of Medicine is associated with functional effects on glucose metabolism.

Original languageEnglish
Pages (from-to)2014-2022
Number of pages9
Issue number10
StatePublished - Oct 2022


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