F. Fallucca et al., AMNIOTIC-FLUID INSULIN AND C-PEPTIDE LEVELS IN DIABETIC AND NONDIABETIC WOMEN DURING EARLY-PREGNANCY, The Journal of clinical endocrinology and metabolism, 81(1), 1996, pp. 137-139
Thanks to the widespread use of amniocentesis, glucose, insulin, and C
peptide have often been measured in amniotic fluid (AF) during late g
estation, but little is known about their concentrations during early
pregnancy. To better understand early fetal p-cell function under norm
al conditions and in the presence of maternal diabetes, we measured gl
ucose, insulin, and C peptide in the AF collected during weeks 15-22 i
n 77 healthy and 9 diabetic women undergoing amniocentesis for clinica
l indications and compared the results with those obtained during late
pregnancy (weeks 34-36). The AFC peptide concentration was higher in
diabetic women (102 +/- 53 vs. 38 +/- 2 pmol/L), in the women with a f
amily history of diabetes (41 +/- 6 vs. 35 +/- 2 pmol/L), after the 19
th week of gestation (46 +/- 5 vs. 35 +/- 2 pmol/L; in the presence of
lower glucose concentrations), and in the presence of maternal plasma
glucose levels greater than 5.56 mmol/L (42 +/- 3.5 us. 34 +/- 2 pmol
/L). The comparison between early and late gestation showed decreasing
glucose and increasing C peptide concentrations in both healthy and d
iabetic women (in the latter, C peptide values were always 3 times hig
her), whereas the insulin concentration was increased in late gestatio
n only in diabetic women. The AFC peptide/insulin molar ratio increase
d throughout pregnancy in both healthy (from 0.97 +/- 0.06 to 4.3 +/-
1.2) and diabetic (from 2.9 +/- 1.1 to 13.2 +/- 1.6) women. These para
llel changes suggest that the fetal clearance and/or degradation of in
sulin and C peptide may greatly change during both normal and diabetic
gestation.