Mechanisms
Basal-bolus insulin lowers maternal triglycerides in gestational diabetes without changing CETP activity (J Obstet Gynaecol Res 2017)
Original title: Basal-bolus insulin therapy reduces maternal triglycerides in gestational diabetes without modifying cholesteryl ester transfer protein activity
In records from 131 singleton pregnancies with gestational diabetes mellitus, researchers tested whether basal-bolus insulin therapy (BBIT) reduces the excessive rise in maternal triglycerides linked to fetal macrosomia, using the atherogenic index of plasma as a proxy for cholesteryl ester transfer protein (CETP) activity. Multiple regression showed only BBIT, not weight-gain limitation or metformin, significantly reduced maternal triglyceride z-scores (P = 0.011), with a dose-related effect across 73 BBIT-treated versus 58 untreated pregnancies (P = 0.03817). The atherogenic index of plasma stayed within the normal range in both groups. The authors conclude that BBIT's triglyceride-lowering benefit in gestational diabetes is not related to changes in CETP activity.
Original abstract
Aim: Macrosomia in the offspring of overweight/obese mothers with glucose-controlled gestational diabetes mellitus (GDM) is due to excessive rise of maternal triglycerides (TG). We aimed to ascertain whether basal-bolus insulin therapy (BBIT), or other components of the treatment, could reduce TG in GDM.
Methods: We studied the records of 131 singleton pregnancies with GDM, using stepwise multiple linear regression, Mann-Whitney, χ2 , and Jonckheere-Terpstra tests. As maternal TG increased steadily during normal pregnancy, these were transformed as z-scores. The atherogenic index of plasma (AIP) was calculated as a measure of cholesteryl ester transfer protein activity.
Results: Multiple regression showed that only BBIT (but neither limitation of weight gain nor metformin) reduced maternal TG z-scores (P = 0.011). When the 131 pregnancies were split into two groups - without BBIT (n = 58; HbA1c = 5.3 ± 0.3%) and with BBIT (n = 73; HbA1c = 5.4 ± 0.6; P = 0.2005) - we observed that BBIT (n = 73) reduced maternal TG z-scores in a dose-related fashion (Jonckheere-Terpstra P = 0.03817). The atherogenic index of plasma remained within normal range in both groups.
Conclusion: BBIT (but not weight gain control nor metformin) reduced maternal TG in mothers with glucose-controlled GDM. This beneficial effect of BBIT was not related to changes in the cholesteryl ester transfer protein activity.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.