The Impact of Liraglutide on Glucose Tolerance and the Risk of Type 2 Diabetes in Women With Previous Pregnancy-induced Diabetes

It is well-known that women with previous gestational diabetes mellitus are in risk of developing type 2 diabetes later in life; approximately half of the women develop overt type 2 diabetes within the first 10 years after pregnancy. Knowing this, we want to examine the effect of the type 2 diabetes medicine, liraglutide (Victoza), in women with previous gestational diabetes with the aim of reducing the risk of developing type 2 diabetes.


Eligibility Criteria:
Inclusion Criteria for women with previous GDM:

* Informed oral and written consent
* Previous diagnosis of GDM according to current Danish guidelines (mainly PG concentrationa t 120 min after 75 g OGTT ≥ 9.0 mM) during pregnancy within the last 5 years
* Age \>18 years
* 25 kg/m2 \< BMI \< 45 kg/m2
* NGT, IFG and or IGT
* Safe contraception and negative pregnancy test

Exclusion Criteria for women with previous GDM:

* Patients with diabetes
* HbA1c ≥6.5%
* Patients with previous pancreatitis or previous neoplasia
* Pregnant or breast feeding women
* Anaemia (haemoglobin \<7 mM)
* Women planning to become pregnant within the next 5 years
* Women using other contraception than intrauterine device (IUD) or oral contraceptives. Women who do not use safe contraception will be offered application of an IUD.
* Women treated with statins, corticosteroids or other hormone therapy (except estrogens and gestagens)
* Ongoing abuse of alcohol or narcotics
* Impaired hepatic function (liver transaminases \>3 times upper normal limit)
* Impaired renal function (se-creatinine \>120 μM and/or albuminuria)
* Uncontrolled hypertension (systolic blood pressure \>180 mmHg, diastolic blood pressure \>100 mmHg)
* Any condition that the investigator feels would interfere with trial participation
* Receiving any investigational drug within the last 3 months

Inclusion criteria for women without previous GDM:

* Informed oral and written consent
* Age \>18 years
* 25 kg/m2 \< BMI \< 45 kg/m2
* NGT
* Safe contraception and negative pregnancy test
* Pregnancy within the last ten years without GDM

Exclusion Criteria for women without previous GDM :

* Pregnant or breast feeding women
* Anaemia (haemoglobin \<7 mM)

Inclusion Criteria for women without previous GDM and without NAFLD:

* Informed oral and written consent
* Age \>18 years
* 25 kg/m2 \< BMI \< 45 kg/m2
* NGT
* At least one pregnancy witin the last ten years without GDM

Exclusion Criteria for women without previous GDM and without NAFLD:

* Pregnant or breast feeding women
* Anaemia (haemoglobin \<7 mM)
* Steatosis as assessed by ultrasound scanning
* Recieving any investigational drug within the last 3 months
* Any condition that the investigator feels would interfere with the trial participation

Inclusion Criteria for women with biopsi-verified NAFLD:

* Informed oral and written consent
* Women with known NAFLD or NASH
* Age \>18 years
* 25 kg/m2 \< BMI \< 45 kg/m2
* NGT
* At least one prior pregnancy

Exclusion Criteria for women with biopsi-verified NAFLD:

* women with established cirrhosis
* Pregnant or breast feedning women
* Anaemia (haemoglobin \<7 mM)
* Women treated with statins, corticosteroids or other hormone therapy ( except oestrogens and gestagens)
* Ongoing abuse of alcohol or narcotics
* Impaired renal function (se-creatinine \> 120 μM and/or albuminuria)
* Uncontrolled hypertension (systolic blood pressure \> 180 mmHg, diastolic blood presure \> 100 mmHg)
* Any condition that the investigator feels would interfere with trial participation