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[Peptide C and insulin after delivery in women with gestational diabetes]
M Kinalski1, W Zarzycki, B Zarzycka
1Zakładu Mieśni Gładkich Narzadu Rodnego, Instytutu Połoznictwa i Chorób Kobiecych.
Gestational diabetes is a disease appearing in many forms. Up till now the etiopathogenesis was not clearly defined. It has been suggested that counterregulatory of pregnancy or diminished B-cells could the major contributory factors. The aim of the present study was to retrospective verify the diagnoses of gestational diabetes. The investigation was carried out in 42 women aged 25-39 yrs, mean age 30 +/- 6 yrs. Diabetes was diagnosed in the 2nd, and 3rd, trimesters of pregnancy, 30 women were treated by diet only, 25 kcal/kg b.w. depending on weight, and 12 patients had intensified insulin therapy of mean daily dose 18 +/- 8 U. Three to nine months after delivery a glucose tolerance test as well as estimation of C-peptide and insulin concentration by RIA in basic conditions and after administration of 1 mg of glucagon were performed. In the group of women treated by diet only, normal values of glycaemia in glucose tolerance test were observed. C-peptide concentration measured before administration of glucagon was 1.15 +/- 0.49 ng/ml and after administration of 1 mg of glucagon was 3.14 +/- 1.44 ng/ml. In the majority of patients treated during pregnancy with insulin the results of oral glucose tolerance test were pathological. The concentrations of C-peptide in the test with glucagon were significantly lower (0.33 +/- 0.16 and 0.38 +/- 0.32 ng/ml). The concentrations of insulin were much lower in comparison to women treated with diet and healthy controls, these results suggest that, if gestational diabetes could be controlled by diet only, disturbances of carbohydrate metabolism would disappear, however, if insulin therapy was necessary during pregnancy, disturbances of the carbohydrate metabolism would be prolonged.
Gestational diabetes is a disease appearing in many forms. Up till now the etiopathogenesis was not clearly defined. It has been suggested that counterregulatory of pregnancy or diminished B-cells could the major contributory factors. The aim of the present study was to retrospective verify the diagnoses of gestational diabetes. The investigation was carried out in 42 women aged 25-39 yrs, mean age 30 +/- 6 yrs. Diabetes was diagnosed in the 2nd, and 3rd, trimesters of pregnancy, 30 women were treated by diet only, 25 kcal/kg b.w. depending on weight, and 12 patients had intensified insulin therapy of mean daily dose 18 +/- 8 U. Three to nine months after delivery a glucose tolerance test as well as estimation of C-peptide and insulin concentration by RIA in basic conditions and after administration of 1 mg of glucagon were performed. In the group of women treated by diet only, normal values of glycaemia in glucose tolerance test were observed. C-peptide concentration measured before administration of glucagon was 1.15 +/- 0.49 ng/ml and after administration of 1 mg of glucagon was 3.14 +/- 1.44 ng/ml. In the majority of patients treated during pregnancy with insulin the results of oral glucose tolerance test were pathological. The concentrations of C-peptide in the test with glucagon were significantly lower (0.33 +/- 0.16 and 0.38 +/- 0.32 ng/ml). The concentrations of insulin were much lower in comparison to women treated with diet and healthy controls, these results suggest that, if gestational diabetes could be controlled by diet only, disturbances of carbohydrate metabolism would disappear, however, if insulin therapy was necessary during pregnancy, disturbances of the carbohydrate metabolism would be prolonged.