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Glucagon stimulation test: assessment of beta-cell function in gestational diabetes mellitus
M L Jacobs1, S Verhoog, W H van der Linden
1Department of Internal Medicine III and Clinical Endocrinology, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Objective:
Because women with gestational diabetes mellitus have a risk of up to 60% for the later development of type II diabetes, we used the intravenous glucagon stimulation test to evaluate beta-cell function in pregnant women.
Patients:
Twenty-seven pregnant women with one or more risk factors for gestational diabetes had an intravenous beta-cell stimulation test. Glucose, C-peptide and insulin levels were measured at baseline and 5, 10 and 15 min after the administration of 1 mg glucagon. The women were classified using the 75-g oral glucose tolerance test according to World Health Organization criteria. During the oral glucose tolerance test glucose, C-peptide and insulin levels were measured at baseline and at 2 h.
Results:
Insulin and C-peptide responses were significantly lower in pregnant women with impaired glucose tolerance and diabetes compared with women with normal glucose tolerance.
Conclusion:
This study shows gradually decreasing insulin secretion from normal to subnormal in pregnant women without and with glucose intolerance, and diabetes mellitus, respectively.