Kitzmiller J L, Tanenberg R J, Aoki T T, Tabatabaii A, Gleason R, Jewett J F, Hare J W, Soeldner J S
Obstet Gynecol. 1980 Oct;56(4):440-5.
Pancreatic alpha cell response to oral alanine was assessed in the third trimester of pregnancy and in the puerperium in 16 insulin-dependent diabetic and 7 normal pegnant women. Insulin response was also measured in the nondiabetic subjects. The nondiabetic subjects had higher basal glucagon and insulin levels as well as a greater response to oral alanine stimulation at 34 weeks' gestation than at 6 weeks post partum. In addition, basal levels of both hormones remained low at a time remote from pregnancy (9 months post partum), indicating both hyperinsulinemia and hyperglucagonemia in the postabsorptive state in normal human pregnancy. The secretory response of glucagon and insulin or oral alanine was blunted at 6 weeks post partum in the nondiabetic subjects. This suggests that the late puerperium may not be an appropriate "nonpregnant control period" for metabolic studies. During pregnancy, basal and stimulated glucagon levels were not significantly different in diabetic and normal women. Despite higher concentrations of blood glucose in diabetic women, basal and stimulated glucagon secretion was equivalent in the 2 groups. No pegnancy-induced increment in glucagon secretion was evident in insulin-treated diabetic subjects. Thus hyperglucagonemia does not contribute to the increased requirements for insulin during pregnancy in these women.
对16名胰岛素依赖型糖尿病孕妇和7名正常孕妇在妊娠晚期和产褥期的胰腺α细胞对口服丙氨酸的反应进行了评估。同时也对非糖尿病受试者的胰岛素反应进行了测量。非糖尿病受试者在妊娠34周时的基础胰高血糖素和胰岛素水平较高，对口服丙氨酸刺激的反应也比产后6周时更大。此外，在远离妊娠的时期（产后9个月），这两种激素的基础水平仍然较低，表明正常妊娠的吸收后状态存在高胰岛素血症和高胰高血糖素血症。非糖尿病受试者在产后6周时胰高血糖素和胰岛素对口服丙氨酸的分泌反应减弱。这表明产褥后期可能不是代谢研究的合适“非妊娠对照期”。在怀孕期间，糖尿病女性和正常女性的基础和刺激后胰高血糖素水平没有显著差异。尽管糖尿病女性的血糖浓度较高，但两组的基础和刺激后胰高血糖素分泌相当。在接受胰岛素治疗的糖尿病受试者中，没有明显的妊娠诱导的胰高血糖素分泌增加。因此，高胰高血糖素血症对这些女性怀孕期间胰岛素需求的增加没有影响。
