{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:34:41Z","timestamp":1790278481426,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine obstetrical and neonatal outcomes across maternal glucose profiles at the population level and to explore insulin sensitivity and beta\u2010cell function across profiles in an independent, well\u2010phenotyped cohort for potential pathophysiologic explanation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods<\/jats:title>\n                    <jats:p>\n                      Observational cohort study of all pregnancies with gestational diabetes screening between October 2008 and December 2018 resulting in live singleton birth in Alberta, Canada (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009436,773) were categorized into seven maternal glucose profiles: (1) normal 50\u2009g\u2010glucose challenge test (nGCT), (2) normal 75\u2010g OGTT (nOGTT), (3) isolated elevated 1\u2009h post\u2010load glucose (ePLPG1), (4) isolated elevated 2\u2009h post\u2010load glucose (ePLPG2), (5) elevated 1 and 2\u2009h post\u2010load glucose (ePLPG12), (6) isolated elevated FPG (eFPG), and (7) elevated FPG\u2009+\u2009elevated 1\u2010h and\/or 2\u2010h PLG (Combined). Primary outcomes were large for gestational age (LGA) and neonatal intensive care unit (NICU) admission rates. An independent observational cohort of 1451 women was examined for measures of beta\u2010cell function (ISSI\u20102, insulinogenic index\/HOMA\u2010IR) and insulin sensitivity\/resistance (Matsuda index, HOMA\u2010IR) by similar maternal glucose profiles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pregnancies with elevated FPG, either isolated or combined, had higher adverse events and lower insulin sensitivity. The combination of elevated FPG\u2009+\u2009elevated 1\u2010h and\/or 2\u2010h PLG had the highest rates of LGA(20.9%), NICU admissions (14.7%), and lowest insulin sensitivity as measured by Matsuda index and HOMA\u2010IR, and beta\u2010cell function as measured by ISSI\u20102 and Insulinogenic index\/HOMA\u2010IR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated fasting plasma glucose, either alone or combined with post\u2010load glucose elevation is associated with worse outcomes than isolated post\u2010load glucose elevation, possibly due to higher degrees of insulin resistance. Future work is needed to better understand these differences, and explore whether tailored treatment of GDM can improve neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.15205","type":"journal-article","created":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T02:43:28Z","timestamp":1692413008000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Gestational diabetes: One size does not fit all\u2014an observational study of maternal and neonatal outcomes by maternal glucose profile"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7670-4923","authenticated-orcid":false,"given":"Roseanne O.","family":"Yeung","sequence":"first","affiliation":[{"name":"Division of Endocrinology &amp; Metabolism and Office of Lifelong Learning\/Physician Learning Program, Faculty of Medicine &amp; Dentistry University of Alberta  Alberta Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Retnakaran","sequence":"additional","affiliation":[{"name":"Division of Endocrinology University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anamaria","family":"Savu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Alberta  Alberta Edmonton Canada"},{"name":"Canadian VIGOUR Centre University of Alberta  Alberta Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7865-9161","authenticated-orcid":false,"given":"Sonia","family":"Butalia","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Departments of Medicine and Community Health Sciences University of Calgary  Alberta Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2239-3944","authenticated-orcid":false,"given":"Padma","family":"Kaul","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Alberta  Alberta Edmonton Canada"},{"name":"Canadian VIGOUR Centre University of Alberta  Alberta Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.2021.7217"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.DIABRES.2019.107841\/ATTACHMENT\/1AAFF24F-478F-4F48-B444-E709EA273D80\/MMC1.XML"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002726"},{"key":"e_1_2_11_5_1","unstructured":"Diabetes Canada | clinical practice guidelines\u2014chapter 36: Diabetes and Pregnancy. 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