Profiles of intermediary metabolites in insulin-dependent pregnant diabetic women with or without endogenous insulin production.

Abstract

The levels of glucose, free fatty acids (FFA), glycerol, 3-hydroxybutyrate (3-HB), cyclic AMP, and C-peptide immunoreactivity (CPR) were determined in venous plasma samples taken every half hour during an 8-h period under standardized conditions in 10 insulin-dependent pregnant women. The metabolic profiles were determined in each trimester of pregnancy. The women were divided into two groups, one with (group I: 3B, 1C, and 1D according to White's classification) and one without (group II: 1B, 3C, and 1D) measurable plasma CPR levels. Plasma glucose values were significantly higher (P less than 0.01) with greater variability in group II than in group I in the first and second trimesters, while no such difference was found in the third trimester of pregnancy. FFA, glycerol, 3-HB, and cyclic AMP levels were not different between the groups in any trimester of pregnancy. Amniotic fluid CPR was higher and skinfold thickness of the newborn greater in group II than in group I. Neonatal complications occurred only in infants of group II mothers. It is concluded that determination of plasma CPR in diabetic women in early pregnancy could give additional prognostic information to that obtained by the White classification.