Diabetes & Metabolism Journal

Original Article

Insulin Secretion and Incretin Hormone Concentration in Women with Previous Gestational Diabetes Mellitus: Sung Hoon Yu, Bongjun Cho, Yejin Lee, Eunhye Kim, Sung Hee Choi, Soo Lim, Ka Hee Yi, Young Joo Park, Kyong Soo Park, Hak Chul Jang; Diabetes Metab J. 2011;35(1):58-64. Published online February 28, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.1.58

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Background

We examined the change in the levels of incretin hormone and effects of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) on insulin secretion in women with previous gestational diabetes (pGDM).

Methods

A 75-g oral glucose tolerance test (OGTT) was conducted on 34 women with pGDM. In addition, 11 women with normal glucose tolerance, matched for age, height and weight, were also tested. The insulin, GIP, GLP-1, and glucagon concentrations were measured, and their anthropometric and biochemical markers were also measured.

Results

Among 34 women with pGDM, 18 had normal glucose tolerance, 13 had impaired glucose tolerance (IGT) and 1 had diabetes. No significant differences were found in GLP-1 concentration between the pGDM and control group. However, a significantly high level of glucagon was present in the pGDM group at 30 minutes into the OGTT. The GIP concentration was elevated at 30 minutes and 60 minutes in the pGDM group. With the exception of the 30-minute timepoint, women with IGT had significantly high blood glucose from 0 to 120 minutes. However, there was no significant difference in insulin or GLP-1 concentration. The GIP level was significantly high from 0 to 90 minutes in patients diagnosed with IGT.

Conclusion

GLP-1 secretion does not differ between pGDM patients and normal women. GIP was elevated, but that does not seem to induce in increase in insulin secretion. Therefore, we conclude that other factors such as heredity and environment play important roles in the development of type 2 diabetes.

Citations

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Association of GLP-1 secretion with parameters of glycemic control in women after gestational diabetes mellitus
Eleni Pappa, Kristina Busygina, Saori Harada, Hana Hermann, Cornelia Then, Andreas Lechner, Uta Ferrari, Jochen Seissler
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Inadequate Glucagon Suppression During OGTT in Prediabetes: A Systematic Review and Meta-analysis
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Journal of Korean Medical Science.2022;[Epub] CrossRef
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Diabetes/Metabolism Research and Reviews.2014; 30(8): 701. CrossRef
Reduced postprandial GLP‐1 responses in women with gestational diabetes mellitus
L. Bonde, T. Vilsbøll, T. Nielsen, J. I. Bagger, J. A. Svare, J. J. Holst, S. Larsen, F. K. Knop
Diabetes, Obesity and Metabolism.2013; 15(8): 713. CrossRef
Women with normal glucose tolerance and a history of gestational diabetes show significant impairment of β-cell function at normal insulin sensitivity
P. Molęda, K. Homa, K. Safranow, Z. Celewicz, A. Fronczyk, L. Majkowska
Diabetes & Metabolism.2013; 39(2): 155. CrossRef

Review

The Incretins and Pancreatic β-Cells: Use of Glucagon-Like Peptide-1 and Glucose-Dependent Insulinotropic Polypeptide to Cure Type 2 Diabetes Mellitus: Mi-Hyun Kim, Moon-Kyu Lee; Korean Diabetes J. 2010;34(1):2-9. Published online February 28, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.1.2

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Abstract PDF PubReader

Type 2 diabetes mellitus (T2DM) is increasing in prevalence worldwide. The complications associated with T2DM result in increased mortality and financial cost for those affected. T2DM has long been known to be associated with insulin resistance in peripheral tissues and a relative degree of insulin deficiency. However, the concept that insulin secretion and insulin sensitivity are not linked through a hyperbolic relationship in T2DM has continuously been demonstrated in many clinical trials. Thus, in order to prevent and treat T2DM, it is necessary to identify the substance(s) that will improve the function and survival of the pancreatic β-cells in both normal and pathologic conditions, so that production and secretion of insulin can be enhanced. Incretin hormones, such as glucagon-like peptide (GLP)-1 and glucose-dependent insulinotropic polypeptide (GIP), have been shown to lower the postprandial and fasting glucose and the glycated hemoglobin levels, suppress the elevated glucagon level, and stimulate glucose-dependent insulin synthesis and secretion. In this report, we will review the biological actions and mechanisms associated with the actions of incretin hormones, GLP-1 and GIP, on β-cell health and compare the differences between GLP-1 and GIP.

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