{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:35:11Z","timestamp":1792481711647,"version":"4.5.0"},"reference-count":16,"publisher":"American Diabetes Association","issue":"6","license":[{"start":{"date-parts":[[2016,12,1]],"date-time":"2016-12-01T00:00:00Z","timestamp":1480550400000},"content-version":"vor","delay-in-days":199,"URL":"http:\/\/www.diabetesjournals.org\/site\/license"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K24 DK094872-03"],"award-info":[{"award-number":["K24 DK094872-03"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["T32 DK007028-41"],"award-info":[{"award-number":["T32 DK007028-41"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008985","name":"Diab\u00e9te Qu\u00e9bec","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008985","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","award":["20697"],"award-info":[{"award-number":["20697"]}],"id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP 115071"],"award-info":[{"award-number":["MOP 115071"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000041","name":"American Diabetes Association","doi-asserted-by":"publisher","award":["1-15-ACE-26"],"award-info":[{"award-number":["1-15-ACE-26"]}],"id":[{"id":"10.13039\/100000041","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To characterize physiologic subtypes of gestational diabetes mellitus (GDM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Insulin sensitivity and secretion were estimated in 809 women at 24\u201330 weeks' gestation, using oral glucose tolerance test\u2013based indices. In women with GDM (8.3%), defects in insulin sensitivity or secretion were defined below the 25th percentile in women with normal glucose tolerance (NGT). GDM subtypes were defined based on the defect(s) present.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Relative to women with NGT, women with predominant insulin sensitivity defects (51% of GDM) had higher BMI and fasting glucose, larger infants (birth weight z score 0.57 [\u22120.01 to 1.37] vs. 0.03 [\u22120.53 to 0.52], P = 0.001), and greater risk of GDM-associated adverse outcomes (57.6 vs. 28.2%, P = 0.003); differences were independent of BMI. Women with predominant insulin secretion defects (30% of GDM) had BMI, fasting glucose, infant birth weights, and risk of adverse outcomes similar to those in women with NGT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Heterogeneity of physiologic processes underlying hyperglycemia exists among women with GDM. GDM with impaired insulin sensitivity confers a greater risk of adverse outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc15-2672","type":"journal-article","created":{"date-parts":[[2016,5,14]],"date-time":"2016-05-14T05:25:58Z","timestamp":1463203558000},"page":"1052-1055","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":231,"title":["Heterogeneous Contribution of Insulin Sensitivity and Secretion Defects to Gestational Diabetes Mellitus"],"prefix":"10.2337","volume":"39","author":[{"given":"Camille E.","family":"Powe","sequence":"first","affiliation":[{"name":"Diabetes Unit, Massachusetts General Hospital, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Allard","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Sherbrooke, Qu\u00e9bec, Canada"},{"name":"Centre de Recherch\u00e9 Clinique \u00c9tienne-Le Bel of the Centre Hospitalier Universitaire de Sherbrooke, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Claude","family":"Battista","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Sherbrooke, Qu\u00e9bec, Canada"},{"name":"Centre de Recherch\u00e9 Clinique \u00c9tienne-Le Bel of the Centre Hospitalier Universitaire de Sherbrooke, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Doyon","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Sherbrooke, Qu\u00e9bec, Canada"},{"name":"Centre de Recherch\u00e9 Clinique \u00c9tienne-Le Bel of the Centre Hospitalier Universitaire de Sherbrooke, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Bouchard","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Sherbrooke, Qu\u00e9bec, Canada"},{"name":"Centre de Recherch\u00e9 Clinique \u00c9tienne-Le Bel of the Centre Hospitalier Universitaire de Sherbrooke, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Ecker","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA"},{"name":"Division of Maternal-Fetal Medicine, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Perron","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Sherbrooke, Qu\u00e9bec, Canada"},{"name":"Centre de Recherch\u00e9 Clinique \u00c9tienne-Le Bel of the Centre Hospitalier Universitaire de Sherbrooke, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose C.","family":"Florez","sequence":"additional","affiliation":[{"name":"Diabetes Unit, Massachusetts General Hospital, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"},{"name":"Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Thadhani","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA"},{"name":"Division of Nephrology, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-France","family":"Hivert","sequence":"additional","affiliation":[{"name":"Diabetes Unit, Massachusetts General Hospital, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"},{"name":"Universit\u00e9 de Sherbrooke, Qu\u00e9bec, Canada"},{"name":"Centre de Recherch\u00e9 Clinique \u00c9tienne-Le Bel of the Centre Hospitalier Universitaire de Sherbrooke, Qu\u00e9bec, Canada"},{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2016,5,16]]},"reference":[{"key":"2022031219382026700_B1","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1056\/NEJMoa0707943","article-title":"Hyperglycemia and adverse pregnancy outcomes","volume":"358","author":"Metzger","year":"2008","journal-title":"N Engl J Med"},{"key":"2022031219382026700_B2","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1172\/JCI110398","article-title":"Physiologic evaluation of factors controlling glucose tolerance in man: measurement of insulin sensitivity and beta-cell glucose sensitivity from the response to intravenous glucose","volume":"68","author":"Bergman","year":"1981","journal-title":"J Clin Invest"},{"key":"2022031219382026700_B3","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.2337\/diab.42.11.1663","article-title":"Quantification of the relationship between insulin sensitivity and beta-cell function in human subjects. Evidence for a hyperbolic function","volume":"42","author":"Kahn","year":"1993","journal-title":"Diabetes"},{"key":"2022031219382026700_B4","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1210\/jc.2013-4016","article-title":"TNF\u03b1 dynamics during the oral glucose tolerance test vary according to the level of insulin resistance in pregnant women","volume":"99","author":"Guillemette","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"2022031219382026700_B5","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.2337\/dc12-1731","article-title":"Lower adiponectin levels at first trimester of pregnancy are associated with increased insulin resistance and higher risk of developing gestational diabetes mellitus","volume":"36","author":"Lacroix","year":"2013","journal-title":"Diabetes Care"},{"key":"2022031219382026700_B6","doi-asserted-by":"crossref","first-page":"e010031","DOI":"10.1136\/bmjopen-2015-010031","article-title":"Genetics of Glucose regulation in Gestation and Growth (Gen3G): a prospective prebirth cohort of mother\u2013child pairs in Sherbrooke, Canada","volume":"6","author":"Guillemette","year":"2016","journal-title":"BMJ Open"},{"key":"2022031219382026700_B7","doi-asserted-by":"crossref","first-page":"676","DOI":"10.2337\/dc10-0719","article-title":"International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy","volume":"33","author":"Metzger","year":"2010","journal-title":"Diabetes Care"},{"key":"2022031219382026700_B8","doi-asserted-by":"crossref","first-page":"796","DOI":"10.2337\/diacare.24.4.796","article-title":"Oral glucose tolerance test indexes for insulin sensitivity and secretion based on various availabilities of sampling times","volume":"24","author":"Stumvoll","year":"2001","journal-title":"Diabetes Care"},{"key":"2022031219382026700_B9","doi-asserted-by":"crossref","first-page":"295","DOI":"10.2337\/diacare.23.3.295","article-title":"Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity","volume":"23","author":"Stumvoll","year":"2000","journal-title":"Diabetes Care"},{"key":"2022031219382026700_B10","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.2337\/diacare.22.9.1462","article-title":"Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp","volume":"22","author":"Matsuda","year":"1999","journal-title":"Diabetes Care"},{"key":"2022031219382026700_B11","doi-asserted-by":"crossref","first-page":"221","DOI":"10.2337\/diacare.23.2.221","article-title":"Reduced beta-cell compensation to the insulin resistance associated with obesity in members of Caucasian familial type 2 diabetic kindreds","volume":"23","author":"Elbein","year":"2000","journal-title":"Diabetes Care"},{"key":"2022031219382026700_B12","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/1471-2431-13-59","article-title":"A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants","volume":"13","author":"Fenton","year":"2013","journal-title":"BMC Pediatr"},{"key":"2022031219382026700_B13","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1177\/1536867X1501500117","article-title":"Nonparametric pairwise multiple comparisons in independent groups using Dunn\u2019s test","volume":"15","author":"Dinno","year":"2015","journal-title":"Stata J"},{"key":"2022031219382026700_B14","first-page":"17","article-title":"Demonstration of heterogeneity in gestational diabetes by a 400-kcal breakfast meal tolerance test","volume":"65","author":"Cheney","year":"1985","journal-title":"Obstet Gynecol"},{"key":"2022031219382026700_B15","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/dme.12381","article-title":"Trying to understand gestational diabetes","volume":"31","author":"Catalano","year":"2014","journal-title":"Diabet Med"},{"key":"2022031219382026700_B16","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.2337\/dc08-0039","article-title":"Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus","volume":"31","author":"Schaefer-Graf","year":"2008","journal-title":"Diabetes Care"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/care.diabetesjournals.org\/syndication\/doi\/10.2337\/dc15-2672","content-type":"unspecified","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/39\/6\/1052\/626290\/dc152672.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/39\/6\/1052\/626290\/dc152672.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T21:18:10Z","timestamp":1647119890000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/39\/6\/1052\/29446\/Heterogeneous-Contribution-of-Insulin-Sensitivity"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5,16]]},"references-count":16,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2016,5,16]]},"published-print":{"date-parts":[[2016,6,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc15-2672","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5,16]]}}}