Hyperinsulinemia during pregnancy across varying degrees of glucose tolerance: An examination of the Kraft database.

Aim Hyperinsulinemia is a known underlying driver of metabolic disease; however, its role in pregnancy complications is less understood due to insulin measurement not being a part of standard clinical assessments. This study aimed to characterize hyperinsulinemia in pregnancy by gestational diabetes (GD) status using Kraft methodology. Methods We analyzed historical data from 926 pregnant women who underwent a 100-g oral glucose tolerance test (OGTT), which included insulin measurement. Subjects were grouped by GD diagnosis status ("Normal", "Borderline", "GD") and insulin responses over 3 h were compared between groups. Results "GD" was diagnosed in 20.3% of the subjects and 13.8% were grouped as "Borderline." The prevalence of hyperinsulinemia using the Kraft algorithm was 33.1% for Kraft IIB and 42.0% for Kraft III. Compared to normal glucose-tolerant mothers, individuals from the "Borderline" group had an exacerbated insulin response, although not to the same magnitude as those with "GD." Conclusions Dynamic OGTT insulin measurement during pregnancy may provide a meaningful assessment of metabolic risk among women who would otherwise not be diagnosed with GD.