Effect of excessive gestational weight gain on insulin sensitivity and insulin kinetics in women with overweight/obesity

Obesity (Silver Spring). 2022 Oct;30(10):2014-2022. doi: 10.1002/oby.23533.


Objective: Obesity increases the risk for pregnancy complications and maternal hyperglycemia. The Institute of Medicine developed guidelines for gestational weight gain (GWG) targets for women with overweight/obesity, but it is unclear whether exceeding these targets has adverse effects on maternal glucose metabolism.

Methods: Insulin sensitivity (assessed using the Matsuda Insulin Sensitivity Index), β-cell function (assessed as insulin secretion rate in relation to plasma glucose), and plasma insulin clearance rate were evaluated using a frequently sampled oral glucose tolerance test at 15 and 35 weeks of gestation in 184 socioeconomically disadvantaged African American women with overweight/obesity.

Results: Insulin sensitivity decreased, whereas β-cell function and insulin clearance increased from 15 to 35 weeks of gestation in the entire group. Compared with women who achieved the recommended GWG, excessive GWG was associated with a greater decrease in insulin sensitivity between 15 and 35 weeks. β-cell function and plasma insulin clearance were not affected by excessive GWG.

Conclusions: These data demonstrate that gaining more weight during pregnancy than recommended by the Institute of Medicine is associated with functional effects on glucose metabolism.

Trial registration: ClinicalTrials.gov NCT01768793.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Blood Glucose
  • Body Mass Index
  • Female
  • Gestational Weight Gain*
  • Humans
  • Insulin
  • Insulin Resistance*
  • Obesity / complications
  • Overweight / complications
  • Pregnancy
  • Pregnancy Complications* / etiology
  • Weight Gain


  • Blood Glucose
  • Insulin

Associated data

  • ClinicalTrials.gov/NCT01768793