Abstract
We have reported evidence of ↑ fetal B-cell function [C-P/G] in umbilical cord plasma from IDM, including gestational diabetics with minimal degrees of glucose intolerance. In this report, we examined the relationships between C-P/G to antenatal (metabolic environment and intrauterine growth) and postnatal (glucose homeostasis) events in 87 term IDM (White Classes A-D) with uncomplicated neonatal courses. Retrospectively, maternal hemoglobin Alc (HbAlc) at term correlated with C-P/G (r=.3450, p<.01) and adiposity as reflected in skin fold thickness measurements (p<.05) and weight/height ratio (p<.01). Thus, even in tightly regulated diabetics, gradations of metabolic control reflected in HbAlc elicit ↑ B-cell function which is expressed in birthweight and adiposity. Prospectively, C-P/G correlated with the nadir of plasma glucose in the first 4 hours of life (r= .4976, p<.01) as well as with rate of glucose disposal (Kt r= .5830, p<.01) and acute B-cell stimulatory responses (ΔC-P r= .7128, p<.01) in a subgroup of IDM challenged with intravenous glucose at 2 hours of life. Thus, cord C-P/G relationships at the pivotal transition between in utero and extrauterine life are sensitive measures of ongoing B-cell function providing a retrospective index of antenatal fetal metabolic environment and augmented growth and a prospective index of altered neonatal glucose homeostasis.
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Ogata, E., Metzger, B., Freinkel, N. et al. 1168 CORD PLASMA C-PEPTIDE/GLUCOSE [C-P/G] IN INFANTS OF DIABETIC MOTHERS [IDM]: RETROSPECTIVE AND PROSPECTIVE INDEX OF B-CELL FUNCTION. Pediatr Res 15 (Suppl 4), 637 (1981). https://doi.org/10.1203/00006450-198104001-01194
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DOI: https://doi.org/10.1203/00006450-198104001-01194