Takizawa Motoi, Kaneko Takashi, Kohno Keiko, Fukada Yukihito, Hoshi Kazuhiko
Department of Obstetrics and Gynecology, Yamanashi Medical University, Tamaho, Yamanashi, Japan.
Acta Obstet Gynecol Scand. 2003 Dec;82(12):1080-5. doi: 10.1046/j.1600-0412.2003.00187.x.
We verified whether a misdiagnosis of gestational diabetes mellitus can result in pregnant women when glucose tolerance has deteriorated after a low-carbohydrate meal, and tried to elucidate the mechanism behind the different outcome of the test.
Twenty-seven pregnant women were given directions for their evening meal the day before each of two 75-g oral glucose tolerance tests (OGTT). The evening meal was either a low-carbohydrate meal (carbohydrate, 6.7%; Low), or a high-carbohydrate meal (carbohydrate, 85.7%; High).
The OGTT showed that the glucose tolerance was significantly impaired after Low than after High, with a significant increase of fasting plasma non-esterified fatty acids (NEFA) level. Moreover, the insulinogenic index (I-I) after High significantly decreased than that after Low.
The present data suggests that there is a risk of misdiagnosis of impaired glucose tolerance with only one intake of this extremely low-carbohydrate meal on the evening before testing. The decrease of insulin secretion and the activation of glucose-fatty acid cycle may be considered as the mechanism.
我们验证了在低碳水化合物餐后葡萄糖耐量恶化时，妊娠期糖尿病的误诊是否会发生在孕妇身上，并试图阐明该测试不同结果背后的机制。
在两次75克口服葡萄糖耐量试验（OGTT）的前一天晚上，对27名孕妇的晚餐给予指导。晚餐要么是低碳水化合物餐（碳水化合物，6.7%；低），要么是高碳水化合物餐（碳水化合物，85.7%；高）。
OGTT显示，与高碳水化合物餐相比，低碳水化合物餐后葡萄糖耐量显著受损，空腹血浆非酯化脂肪酸（NEFA）水平显著升高。此外，高碳水化合物餐后的胰岛素生成指数（I-I）比低碳水化合物餐后显著降低。
目前的数据表明，在测试前一晚仅摄入一次这种极低碳水化合物餐，存在糖耐量受损误诊的风险。胰岛素分泌减少和葡萄糖-脂肪酸循环的激活可能被视为其机制。
