Gestational diabetes & diabetes in pregnancy
Altered postprandial glucose metabolism and enteropancreatic hormone responses during pregnancy following Roux-en-Y gastric bypass: a prospective cohort study
Authors' conclusion
These results provide novel insights into the combined effects of RYGB and pregnancy on postmeal glucose metabolism and enteropancreatic hormone responses during pregnancy, and how these changes associate with an increased risk of postprandial hypoglycemia.
Study context
- Population
- Pregnant women with prior RYGB and matched pregnant women without RYGB; 4-hour mixed meal test in first and third trimestermatched cohort
- Participants
- 23 vs 23
- Exposure
- Women with RYGB vs women without RYGB
- RYGBn = 23
- Without RYGBn = 23reference
- Outcome
- Postprandial glucose metabolism during mixed meal test (MMT)
- Follow-up
- First and third trimester
Methodological detailsmatched on prepregnancy BMI and parity
- Matched on prepregnancy BMI and parity
Main finding
As reported in the abstract
- Earlier and higher peak glucose with RYGB vs without RYGB
- Lower nadir glucose with RYGB vs without RYGB
- Higher frequency of biochemical hypoglycemia (plasma glucose <3.5 mmol/L) with RYGB vs without RYGB
Observational data: associations, not effects.
Further findings
Enteropancreatic hormone responses
- Lower glucose preceded by markedly elevated total GLP-1 and insulin with RYGB
- Total GIP unaltered
- Glucagon lower with RYGB
Associations with nadir plasma glucose
- First trimester: peak and AUC of total GLP-1 and insulin negatively associated with nadir glucose
- Third trimester: early postmeal glucagon response positively associated with nadir glucose
Original publication
Altered postprandial glucose metabolism and enteropancreatic hormone responses during pregnancy following Roux-en-Y gastric bypass: a prospective cohort study. BMJ Open Diabetes Res Care. Published 20 March 2025. doi:10.
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