Gastro-entero-pancreatic hormones in gestational diabetes: response to a protein rich meal.

Abstract

The gastro-entero-pancreatic (GEP) hormone response to glucose ingestion is considerably altered in pregnancy in normal women and gestational diabetics. In normal women, also the GEP hormone response to protein is changed in pregnancy. In the present investigation, the gastrin, gastric inhibitory polypeptide (GIP), gut glucagon-like-immunoreactivity (gut GLI), insulin, pancreatic glucagon, and pancreatic polypeptide (PP) responses to a protein rich meal in pregnancy and postpartum were studied in 10 women with gestational diabetes. Five of the women were overweight and five were normal weight. Fasting and postprandial gut GLI and PP levels were reduced and insulin levels enhanced in pregnancy. No effect of pregnancy on fasting or postprandial gastrin, GIP, or glucagon levels was found. In pregnancy as well as postpartum, insulin levels were higher in the overweight than in the normal weight patients, whereas the concentrations of the other hormones were similar in the two subgroups of gestational diabetics. It is concluded that the GEP hormone response to a protein rich meal is influenced by late pregnancy in gestational diabetics in the same way as in normal women. The physiological consequences of the findings are not known in detail as yet but they may be important to carbohydrate metabolism and gastrointestinal physiology in pregnancy.