Clinical and laboratory peculiarities of pregnancy course complicated with gestational diabetes mellitus and exocrine pancreatic insufficiency

The course of pregnancy can be accompanied by a number of adverse conditions, one of which is gestational diabetes mellitus (GDM). Reduced glucose tolerance is an adaptive mechanism during pregnancy, but the development of GDM is based on a certain decompensation of pancreatic functions, which may affect not only endocrine but also exocrine pancreatic activity (EPA). Aim - to study the anamnestic, clinical and laboratory features of the course of pregnancy with reduced EPA in GDM. Materials and methods. The study involved 112 patients (87 women from the main group, divided into 2 subgroups according to the presence of dyspeptic symptoms; and 25 pregnant women from the control group). Anamnestic data, the course of this pregnancy were studied and enzyme immunoassays for serum trypsinogen (TPG) and fecal elastase-1 (FE-1) concentrations were performed. Statistical analysis conducted using Microsoft Office Excel and MedStat software. The difference between groups was considered significant at p≤0.05. Results. In pregnant women with GDM and reduced EPA, the presence of factors in the anamnesis that potentially affect the development of pancreatic diseases was established. Significantly lower TPG and FE-1 levels were found in the main group compared to the control group. A direct relationship was determined between the degree of reduction in EPA in GDM and clinical manifestations of dyspepsia, as well as with the occurrence of early pregnancy complications. Conclusions. Increasing maternal age, previous gastrointestinal diseases, polycystic ovary syndrome, and obesity are associated with a greater severity of decreased EPA in women with GDM, clinically manifested by the occurrence of dyspeptic manifestations, vomiting of pregnancy, and threatened abortion; laboratory findings were: decreased TPG and FE-1 concentrations, which correlate with the severity of clinical picture. The study was conducted in accordance with principles of the Declaration of Helsinki. Research protocol was approved by local ethics committee of the participating institution. Informed consent was obtained. The authors declare no conflict of interest.