Impaired early‐phase suppression of glucagon secretion after glucose load is associated with insulin requirement during pregnancy in gestational diabetes

Autor: Hideaki Masuzaki, Ai Haraguchi, Norio Abiru, Yoshitaka Mori, Ichiro Horie, Kiyonori Miura, Ai Higashijima, Shoko Natsuda, Atsushi Yoshida, Yuri Hasegawa, Ayako Ito, Atsushi Kawakami, Takao Ando, Satoru Akazawa, Aya Nozaki
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
Blood Glucose
medicine.medical_specialty
Diet therapy
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
030209 endocrinology & metabolism
Type 2 diabetes
Sandwich enzyme‐linked immunosorbent assay
030204 cardiovascular system & hematology
Glucagon
Diseases of the endocrine glands. Clinical endocrinology
03 medical and health sciences
0302 clinical medicine
Pregnancy
Diabetes mellitus
Internal medicine
Glucose Intolerance
Internal Medicine
Medicine
Humans
Hypoglycemic Agents
Insulin
Prospective Studies
Sandwich enzyme-linked immunosorbent assay
Gestational diabetes
business.industry
Glucagon secretion
General Medicine
Articles
Glucose Tolerance Test
medicine.disease
RC648-665
Prognosis
Diabetes
Gestational
Endocrinology
Clinical Science and Care
Diabetes Mellitus
Type 2
Original Article
Female
business
Biomarkers
Follow-Up Studies
Zdroj: Journal of Diabetes Investigation
Journal of Diabetes Investigation, Vol 11, Iss 1, Pp 232-240 (2020)
ISSN: 2040-1124
2040-1116
Popis: Aims/Introduction The role of glucagon abnormality has recently been reported in type 2 diabetes; however, its role in gestational diabetes mellitus (GDM) is still unknown. The glucose intolerance in GDM is heterogeneous, and not all patients require insulin treatment during pregnancy. Here, we investigated whether glucagon abnormality is associated with the requirement for insulin treatment during pregnancy. Materials and Methods A total of 49 pregnant women diagnosed with GDM were enrolled. They underwent a 75‐g oral glucose tolerance test during mid‐gestation, and we measured their plasma glucagon levels (by a new sandwich enzyme‐linked immunosorbent assay) at fasting (0 min), and at 30, 60 and 120 min after glucose load in addition to the levels of plasma glucose and serum insulin. All participants underwent another oral glucose tolerance test at postpartum. Results Of the 49 patients, 15 required insulin treatment (Insulin group) and 34 were treated with diet therapy alone until delivery (Diet group). The early‐phase glucagon secretion after glucose load, as determined by the changes in glucagon from the baseline to 30 min, was paradoxically augmented during mid‐gestation in the Insulin group, but not in the Diet group. The impaired glucagon suppression during mid‐gestation in the Insulin group was not associated with insulin secretory/sensitivity indexes studied, and was ameliorated postpartum, although the plasma glucose levels remained higher in the Insulin group versus the Diet group. Conclusions Impaired early‐phase suppression of glucagon could be associated with the requirement for insulin treatment during pregnancy in patients with GDM.
We evaluated the glucagon responses to oral glucose load in patients with gestational diabetes mellitus using a new sandwich enzyme‐linked immunosorbent assay. We investigated whether the glucagon abnormality is associated with the requirement for insulin treatment during pregnancy.
Databáze: OpenAIRE
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