Study of Pro-insulin Level and Its Role in a Cohort of Women with Gestational Diabetes in Alexandria, Egypt

摘要

To study the levels of serum pro-insulin or pro-insulin/insulin ratio (PIR) in women suffering from gestational diabetes mellitus (GDM), as an additional factor to their insulin resistance state during pregnancy; and to evaluate any change or reversibility of serum pro-insulin or PIR during the postpartum period. The study was conducted on 30 pregnant women in their second or third trimester and 10 age-matched non pregnant , normoglycemic women , as a reference group. The pregnant women were divided into 3 equal groups; normoglycemic women with normal oral glucose tolerance test (OGTT), obese women with GDM and lean women with GDM. Diagnostic OGTT was performed and pro-insulin levels, insulin levels, C-peptide levels, pro-insulin/insulin ratio (PIR) and insulin sensitivity were determined . These tests were repeated after 4-8 weeks of the postpartum period. Serum levels of pro-insulin and the PIR were significantly higher in obese and lean women with GDM than the control and reference groups during pregnancy and after delivery (p=0.0001). Insulin sensitivity index was significantly lower and relative resistance for insulin was significantly higher in GDM women (p<0.0001). After delivery the sensitivity index was significantly higher than during pregnancy in pregnant women, recruited in the study. C-peptide levels were significantly higher in GDM patients versus control and reference groups during pregnancy. After delivery, C-peptide levels were significantly lower in the 3 pregnant groups (p<0.0001). Women with GDM have elevated serum pro-insulin and increased PIR which might serve as a marker for the disease. Moreover, this characteristic profile might be useful for the prediction of gestational diabetes mellitus (GDM).