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Urinary C-peptide in the neonate correlates both to maternal glucose tolerance and to fetal size at birth
N O Lunell1, B Persson, L V Devarajan
1Department of Obstetrics and Gynecology, Huddinge University Hospital, Sweden.
Insights
Maternal gestational diabetes impacts infant insulin production, measurable via urinary C-peptide excretion. This study links maternal glucose tolerance test results to neonatal C-peptide levels, offering insights into fetal development.
Area of Science:
- Endocrinology
- Neonatal Health
- Maternal-Fetal Medicine
Background:
- Gestational diabetes mellitus (GDM) affects maternal carbohydrate metabolism.
- Maternal hyperglycemia can influence fetal development and neonatal metabolic status.
- Assessing neonatal insulin production is crucial for understanding intrauterine effects.
Purpose of the Study:
- To investigate the correlation between maternal glucose tolerance test (GTT) variables and neonatal urinary C-peptide excretion in pregnancies complicated by diabetes.
- To determine if neonatal C-peptide excretion reflects maternal carbohydrate metabolism.
- To evaluate the utility of neonatal urinary C-peptide as a marker for intrauterine effects.
Main Methods:
- Collected data from 18 women with gestational diabetes and 28 pregnant women with type II diabetes.
- Performed oral glucose tolerance tests (OGTT) in the last trimester of pregnancy.
- Measured urinary C-peptide excretion in neonates during the first 12 hours of life.
- Correlated OGTT variables (fasting, 2-hour blood glucose, area under the curve) with neonatal urinary C-peptide and infant skinfold measurements.
Main Results:
- Significant correlations were found between maternal OGTT variables (fasting glucose, 2-hour glucose, glucose curve area) and neonatal urinary C-peptide excretion (r = 0.47, 0.71, 0.60, respectively) in women with gestational diabetes.
- In a combined group of pregnant women with diabetes, neonatal urinary C-peptide excretion correlated significantly with infant skinfold measurements.
- Neonatal urinary C-peptide excretion, a reflection of insulin production, showed sensitivity to maternal carbohydrate metabolism.
Conclusions:
- Neonatal urinary C-peptide excretion is a sensitive indicator of fetal insulin production.
- Maternal glucose metabolism during pregnancy significantly influences neonatal insulin secretion.
- Urinary C-peptide assay in neonates can serve as a valuable tool to study the impact of maternal diabetes on offspring.
Abstract:
In 18 women with gestational diabetes the variables of an oral glucose tolerance test (fasting and 2-hour blood glucose values and area under the blood glucose curve) performed in the last trimester of pregnancy correlated significantly with the urinary C-peptide excretion during the first 12 hours of the life (r = 0.47, 0.71, and 0.60, respectively). In a combined group with 28 type II pregnant diabetic women there was also a significant correlation between the urinary C-peptide excretion of the infants and their skinfold. Assay of the urinary C-peptide excretion of the neonate, reflecting its insulin production, seems to be a sensitive parameter to study the influence of the maternal carbohydrate metabolism in the offspring.