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Effect of normal pregnancy on glucose assimilation, insulin and non-esterified fatty acids levels

par Picard, Claude;Ooms, Henri ;Balasse, Edmond ;Conard, Victor
Référence Diabetologia, 4, 1, page (16-19)
Publication Publié, 1968-01

Article révisé par les pairs

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Résumé :

Insulin and non-esterified fatty acid (NEFA) levels were determined following a rapid intravenous injection of glucose in a control group as well as in early and late normal pregnancy. The peak level of plasma insulin occuring within the first six minutes of the test was higher in early pregnancy than in the control group. This difference thereafter was blunted. - The highest insulinic response was obtained in late pregnancy and was maintained throughout the whole test. - There were no differences in NEFA concentrations in the control and the early pregnant group. - NEFA levels were the highest in late pregnancy. - The hypothesis we have considered to explain these variations is a double one. It brings into play an enzymatic destruction of insulin by the placenta early in pregnancy. At this time the CGP-HPL levels are not yet sufficient to exhibit an antagonistic action on the maternal glucose tolerance. This would induce a pancreatic hyperplasia very early during pregnancy. This hyperplasia helps to explain why, after the same glucose stimulus, the insulin response is transiently higher during early pregnancy. The increase in circulating insulin would explain the improvement of the glucose tolerance noted at this time. - On the contrary, in late pregnancy, the high levels of CGP-HPL increase the NEFA levels to a maximum, and consequently lower the tissue utilisation of glucose. The insulin produced in greater quantity is deviated from its usual utilization and remains at a higher level and for a longer period in the circulation. © 1968 Springer-Verlag.