Subclinical abnormalities of glucose metabolism in Brazilian women with a history of gestational diabetes mellitus

Background. To evaluate insulin release and insulin sensitivity in women with prior gestational diabetes mellitus (GDM) to gain a better understanding of type 2 diabetes pathogenesis.Methods. GDM women were individually matched for age, body mass index, and waist/hip ratio with those who were normal glucose tolerant in a previous pregnancy (NGT). All women presented with normal glucose tolerance. Twenty pairs were submitted to the oral glucose tolerance test (OGTT) with plasma glucose, insulin, and C-peptide determinations. of the 20 pairs, 18 participated in hyperglycemic (10.0 mmol/l) clamp experiments with frequent plasma glucose and insulin determinations, allowing us to calculate first- and second-phase insulin release and the insulin sensitivity index. GDM and NGT women were compared using Student's t-test, the Mann-Whitney U-test, Friedman's non-parametric test, and the two proportion test for independent groups.Results. GDM women showed higher glycosylated hemoglobin values; at OGTT, they showed late insulin peak with increased plasma insulin levels only during the second hour, and a similar plasma C-peptide response despite a higher plasma glucose curve; during hyperglycemic clamp procedures, they showed similar biphasic insulin release and insulin sensitivity index. Considering that a woman with previous GDM had a defect in insulin release and/or insulin sensitivity, if its magnitude was at least 25% lower than that of the matched NGT woman, 43.8% showed impairment of first-phase insulin release and 55.6% insulin resistance.Conclusions. GDM women showed some degree of glucose intolerance. It is therefore necessary to follow them for a longer time.

A microscopic survey of the human temporomandibular joint disc

The articular disc of the temporomandibular joint was studied in a foetuses and children group (GI), a dentate group of adults (GII) and an edentulous, elderly group of humans (GIII) by light microscopy. The main, constituent bundles of type I collagen fibres are stratified and are orientated sagittally, transversely and obliquely in the middle portion of the disc. In the thick, posterior portion, transverse bundles constitute the main feature. In the anterior portion of the disc, the fibres are sagittally and obliquely orientated. Type III. collagen fibres, intermingled with type I collagen fibres are present in all groups. The disc is cellular in nature in foetuses and children becoming more fibrous with age. Chondroid cells are observed in all portions of the discs in groups GII and GIII. Elastic fibres are numerous in GI discs and decrease in number in the disc with age. These fibres lie parallel to the collagen fibres in all three portions of the three groups.