[Changes of insulin and C-peptide in pregnancy of gestational diabetes mellitus].
OBJECTIVE: To observe the different changes of plasma insulin and c-peptide in patients with gestational diabetes mellitus (GDM), gestational impaired glucose tolerance (GIGT), normal pregnant women, and to detect the function of beta-cell in patients with gestational impaired glucose metabolism. METHODS: Test the plasma insulin, c-peptide in 48 cases of GDM(group I), 39 cases of GIGT (group II), 39 cases of normal pregnant women (group III) and 22 cases of healthy non-pregnant women (group IV) by radioimmunoassay. RESULTS: (1) In third trimester of group III, insulin, c-peptide levels were higher than those of group IV (P < 0.01). They increased from 28-34 weeks to 38-40 weeks, peaked during delivery. Insulin levels of group I and group II were higher than those of group III (P < 0.01, P < 0.05), but tended to decrease by the end of the third trimester and peaked during delivery. During delivery, there was no significant differences among the three groups. At 28-40 weeks, c-peptide of group I was significantly higher than those in groups II and III (P < 0.01) and was lower than that in group III during delivery (P < 0.05). Insulin and c-peptide of these 3 groups dropped gradually within 2 months after delivery but in group I and II they were significantly higher than those of group III (P < 0.01). CONCLUSION: In third trimester insulin and c-peptide of group I-III increased till delivery, the reason maybe associated with insulin resistance. GDM had the same peaking secretion during delivery with normal pregnant women and GIGT group, this maybe due to the stress during delivery. Insulin levels of most GDM and GIGT were still higher than normal after two month postpartum, and should be followed up carefully.