Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Mar 20;14(1):89320.
doi: 10.5493/wjem.v14.i1.89320.

Future clinical prospects of C-peptide testing in the early diagnosis of gestational diabetes

Charalampos Milionis  1 , Ioannis Ilias  2 , Anastasia Lekkou  2 , Evangelia Venaki  2 , Eftychia Koukkou  2
Affiliations
Review

Future clinical prospects of C-peptide testing in the early diagnosis of gestational diabetes

Charalampos Milionis et al. World J Exp Med. .

Abstract

Gestational diabetes is typically diagnosed in the late second or third trimester of pregnancy. It is one of the most common metabolic disorders among expectant mothers, with potential serious short- and long-term complications for both maternal and offspring health. C-peptide is secreted from pancreatic beta-cells into circulation in equimolar amounts with insulin. It is a useful biomarker to estimate the beta-cell function because it undergoes negligible hepatic clearance and consequently it has a longer half-life compared to insulin. Pregnancy induces increased insulin resistance due to physiological changes in hormonal and metabolic homeostasis. Inadequate compensation by islet beta-cells results in hyperglycemia. The standard oral glucose tolerance test at 24-28 wk of gestation sets the diagnosis. Accumulated evidence from prospective studies indicates a link between early pregnancy C-peptide levels and the risk of subsequent gestational diabetes. Elevated C-peptide levels and surrogate glycemic indices at the beginning of pregnancy could prompt appropriate strategies for secondary prevention.

Keywords: C-peptide; Clinical laboratory techniques; Gestational diabetes; Pregnancy; Secondary prevention.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Insulin synthesis and secretion by the pancreatic beta-cell.
Figure 2
Figure 2
The molecule of proinsulin with its components.
Figure 3
Figure 3
The different stages of prevention in treating gestational diabetes and the development of insulin resistance during pregnancy. Primary prevention can only be sought before conception. Secondary prevention is feasible during the period from conception to around the 20th week of gestation, after which prevention of hyperglycemia is not possible and only complications can be potentially avoided; There is a substantial increase in insulin resistance from gestational week 15 until week 35. Then, it remains stable (or slightly decreases) until delivery and returns to the pre-pregnancy state a few days after parturition.
See this image and copyright information in PMC

References

    1. Wang H, Li N, Chivese T, Werfalli M, Sun H, Yuen L, Hoegfeldt CA, Elise Powe C, Immanuel J, Karuranga S, Divakar H, Levitt N, Li C, Simmons D, Yang X IDF Diabetes Atlas Committee Hyperglycaemia in Pregnancy Special Interest Group. IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group's Criteria. Diabetes Res Clin Pract. 2022;183:109050. - PubMed
    1. Ben-Haroush A, Yogev Y, Hod M. Epidemiology of gestational diabetes mellitus and its association with Type 2 diabetes. Diabet Med. 2004;21:103–113. - PubMed
    1. Dennison RA, Chen ES, Green ME, Legard C, Kotecha D, Farmer G, Sharp SJ, Ward RJ, Usher-Smith JA, Griffin SJ. The absolute and relative risk of type 2 diabetes after gestational diabetes: A systematic review and meta-analysis of 129 studies. Diabetes Res Clin Pract. 2021;171:108625. - PMC - PubMed
    1. Simmons D, Immanuel J, Hague WM, Teede H, Nolan CJ, Peek MJ, Flack JR, McLean M, Wong V, Hibbert E, Kautzky-Willer A, Harreiter J, Backman H, Gianatti E, Sweeting A, Mohan V, Enticott J, Cheung NW TOBOGM Research Group. Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy. N Engl J Med. 2023;388:2132–2144. - PubMed
    1. Catalano PM. Trying to understand gestational diabetes. Diabet Med. 2014;31:273–281. - PMC - PubMed