Background and Aims: Women who develop GDM (gestational diabetes mellitus) have a
relative insulin secretion deficiency, the severity of which may be predictive for later development of
diabetes. This study aimed to investigate the role of fasting plasma glucagon in the prediction of later
development of diabetes in pregnant women with GDM.
Materials and Methods: The study was conducted on 150 pregnant women with GDM after giving
informed oral and written consents and being approved by the research ethical committee according to
the declaration of Helsinki. The study was conducted in two phases, first phase during pregnancy and
the second one was 6 months post-partum, as we measured fasting plasma glucagon before and after
delivery together with fasting and 2 hour post-prandial plasma sugar.
Results: Our findings suggested that glucagon levels significantly increased after delivery in the majority
14/25 (56%) of GDM women who developed type 2 DM within 6 months after delivery compared
to 6/20 (30%) patients with impaired fasting plasma glucose (IFG) and only 22/105 (20%) non
DM women, as the median glucagon levels were 80,76, 55, respectively. Also, there was a high statistical
difference between fasting plasma glucagon post-delivery among diabetic and non-diabetic
women (p ≤ 0.001). These results indicated the useful role of assessing fasting plasma glucagon before
and after delivery in patients with GDM to predict the possibility of type 2 DM.
Conclusion: There is a relatively high glucagon level in GDM patients, which is a significant pathogenic
factor in the incidence of subsequent diabetes in women with a history of GDM. This could be
important in the design of follow-up programs for women with previous GDM.