| Gestational glucose intolerance include Gestational Impaired Glucose Tolerance and Gestational Diabetes Mellitus. It is a common complication of pregnancy which cause many maternal and infant diseases, the incidence is about 10%. Researches show: it increase the incidence of spontaneous abortion at early pregnancy with poor blood glucose control; in a high risk of suffering gestational hypertensive disorder, and the blood pressure is difficult to control, more often develop to pre-eclampsia or even eclampsia, take a serious impact on mother and fetus; the pregnancy women always have infection, diabetic ketoacidosis, cause dystocia even stillbirth, fetal anomaly, prematurity, neonatal hypoglycemia, neonatal respiratory distress syndrome and so on, the maternal after delivery and their descendant have a high incidence of type 2 diabetes mellitus. These complications depend on the control of blood glucose. It means that if we can diagnose gestational glucose intolerance in an early stage and make the blood glucose ideality, we can prevent many complications of maternal and infants.Usually, we diagnose gestational glucose intoleranc by blood glucose level when oral glucose tolerance test, insulin decreases blood glucose. Because of insulin resistance in gestational period, the results of some scholars'reports are always different. The serum insulin level is easy to change by diet, taking hypoglycemic agents and so on, so the actual serum insulin level is hard to measure. More ande more researches are trying to find a better predictor to predict gestational glucose intoleranc, like adipocytokines, glycosylated hemoglobin, C-peptide and so on. C-peptide is been secreted equimolar byβcell of pancreatic islet with insulin, it has little clearance in liver and kidney, and don't have cross reaction with insulin antibodies, it means C-peptide should be a better cytokine on evaluatingβcell's function. In our research, we recorded the serum C-peptide levels when gestational glucose intoleranc, to see if it can evaluate theβcell's function by insulin resistance of pregnant women, and diagnose gestational glucose intoleranc in an early stage, even gave suggestion on if the pregnant woman need insulin treatment.This study is a register-based prospective cohort study.75 pregnant women diagnosed with gestational glucose intoleranc and 50 pregnant women with normal glucose tolerance at our institution between January 2008 and October 2007 were enrolled, record fast (time 0) and at 1 hour,2 hours and 3hours blood glucose and serum C-peptide level after a 75-g oral glucose tolerance test (OGTT). GIGR group:one or more than one index abnormal in OGTT; control group:all the index are in the normal range in OGTT. If a woman's first or second degree relative have diabetes mellitus (DM), that she has a family history of DM, family history group compare with control group who don't have a family history of DM.Result:1. GIGR group compared with control group:the gestational weeks had no statistical differences(P>0.05). GIGR group's BMI, the increased weight at OGTT and IR (24.1±4.3 kg/m2,13.5±3.5 kg/m2,5.2±1.3) is significantly higher than control group (22.1±2.1kg/m2,8.1±1.2kg/m2,2.4±0.5)(P<0.05).54.7% of GIGR group members have DM family history, is significantly higher than control group (22%)(P<0.05). 2. GIGR group fast (time 0),1 hour,2 hours blood glucose after OGTT (6.1±2.2,12.4±2.8,10.2±2.3mmol/L) is significantly higher than control group (4.4±1.3,9.1±2.4,8.8±1.9mmol/L) (P<0.05),3 hours blood glucose had no statistical differences (P>0.05).3. GIGR group 1 hour,2 hours serum C-peptide level after OGTT (11.3±3.51,7.9±3.12pmol/L) is significantly higher than control group (4.6±1.32,2.6±0.41pmol/L) (P<0.05), fast (time 0) and 3 hours serum C-peptide level had no statistical differences (P>0.05).4. In GIGR group, the women's 1 hour,2 hours serum C-peptide level after OGTT who have DM family history (13.4±3.89,8.7±2.65pmol/L) is significantly higher than the women who don't have DM family history (11.9±4.81,7.6±2.68pmol/L) (P<0.05), fast (time 0) and 3 hours serum C-peptide level had no statistical differences (P>0.05).5. In GIGR group, the women's 1 hour after GCT and fast blood glucose after OGTT who have DM family history (9.8±1.9 mmol/L,5.6±1.3 mmol/L) is significantly higher than the women who don't have DM family history (9.4±1.8mmol/L, 5.3±1.9mmol/L) (P<0.01), HbA1c,lhour and 3 hours blood glucose after OGTT had no statistical differences (P>0.05).Conclusion: Monitoring the serum C-peptide level during pregnancy period, can help todetective gestational glucose intoleranc at an early stage, and protect complications byinterfering diet and patient habit.
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