Background: Gestational Diabetes Mellitus (GDM) is a common condition during pregnancy, with significant implications for both mothers and babies. This study explores the interplay between exocrine and endocrine pancreatic functions in pregnant women with diabetes and their association with gastrointestinal (GI) symptoms. Methods: A case-control study involving pregnant women with GDM and those without diabetes was conducted. Data were collected on demographics, clinical profiles, GI symptoms, and relevant parameters. Serum amylase and lipase levels, HbA1c, fasting and post-prandial blood sugar levels were measured. Results: In GDM and pre-existing diabetes groups, fasting blood sugar levels were elevated compared to the control group, albeit less severely than in non-pregnant diabetic populations. Serum amylase levels were significantly reduced in both diabetes groups. No significant differences in serum lipase levels were observed. Well-controlled diabetes was associated with lower serum amylase levels, suggesting a link between glycemic control and exocrine pancreatic function. Discussion: The study highlights the complex relationship between exocrine and endocrine pancreatic functions in pregnant women with diabetes. The moderation of blood sugar levels during pregnancy and the reduction in serum amylase levels in diabetic pregnant women are notable findings, with implications for further research. Conclusion: This study underscores the need for additional research on the intricate relationship between exocrine and endocrine pancreatic functions during pregnancy. Understanding this relationship can lead to improved healthcare practices for pregnant women with diabetes, benefiting both mother and child. Recognition of exocrine pancreatic insufficiency as a cause of GI symptoms in GDM patients may facilitate better symptom management.