dc.contributor.author | Meek, CL | |
dc.contributor.author | Oram, RA | |
dc.contributor.author | McDonald, TJ | |
dc.contributor.author | Feig, DS | |
dc.contributor.author | Hattersley, AT | |
dc.contributor.author | Murphy, HR | |
dc.date.accessioned | 2021-09-30T09:57:28Z | |
dc.date.issued | 2021-06-26 | |
dc.description.abstract | OBJECTIVE: We assessed longitudinal patterns of maternal C-peptide concentration to examine the hypothesis of β-cell regeneration in pregnancy with type 1 diabetes. RESEARCH DESIGN AND METHODS: C-peptide was measured on maternal serum samples from 127 participants (12, 24, and 34 weeks) and cord blood during the Continuous Glucose Monitoring in Women With Type 1 Diabetes in Pregnancy Trial (CONCEPTT). C-peptide was measured using a highly sensitive direct and solid-phase competitive electrochemiluminescent immunoassay. RESULTS: Three discrete patterns of maternal C-peptide trajectory were identified: pattern 1, undetectable throughout pregnancy, n = 74 (58%; maternal C-peptide <3 pmol/L); pattern 2, detectable at baseline, n = 22 (17%; maternal C-peptide 7-272 pmol/L at baseline); and pattern 3, undetectable maternal C-peptide at 12 and 24 weeks, which first became detectable at 34 weeks, n = 31 (24%; maternal C-peptide 4-26 pmol/L at 34 weeks). Baseline characteristics and third trimester glucose profiles of women with pattern 1 and pattern 3 C-peptide trajectories were similar, but women in pattern 3 had suboptimal glycemia (50% time above range) at 24 weeks' gestation. Offspring of women with pattern 3 C-peptide trajectories had elevated cord blood C-peptide (geometric mean 1,319 vs. 718 pmol/L; P = 0.007), increased rates of large for gestational age (90% vs. 60%; P = 0.002), neonatal hypoglycemia (42% vs. 14%; P = 0.001), and neonatal intensive care admission (45% vs. 23%; P = 0.023) compared with pattern 1 offspring. CONCLUSIONS: First maternal C-peptide appearance at 34 weeks was associated with midtrimester hyperglycemia, elevated cord blood C-peptide, and high rates of neonatal complications. This suggests transfer of C-peptide from fetal to maternal serum and is inconsistent with pregnancy-related β-cell regeneration. | en_GB |
dc.description.sponsorship | JDRF | en_GB |
dc.description.sponsorship | Diabetes UK | en_GB |
dc.description.sponsorship | European Foundation for the Study of Diabetes Novo Nordisk Foundation | en_GB |
dc.description.sponsorship | National Institute for Health Research (NIHR) | en_GB |
dc.description.sponsorship | Wellcome Trust | en_GB |
dc.description.sponsorship | Tommy's charity | en_GB |
dc.identifier.citation | Vol. 44 (8), pp. 1826 - 1834 | en_GB |
dc.identifier.doi | 10.2337/dc21-0028 | |
dc.identifier.grantnumber | 17-2011-533 | en_GB |
dc.identifier.grantnumber | 80-2010-585 | en_GB |
dc.identifier.grantnumber | DUK-HKF 17/0005712 | en_GB |
dc.identifier.grantnumber | DUK-HKF 16/0005529 | en_GB |
dc.identifier.grantnumber | NNF19SA058974 | en_GB |
dc.identifier.grantnumber | CDF-2013-06-035 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/127284 | |
dc.language.iso | en | en_GB |
dc.publisher | American Diabetes Association | en_GB |
dc.rights | © 2021 by the American Diabetes Association | en_GB |
dc.title | Reappearance of C-Peptide During the Third Trimester of Pregnancy in Type 1 Diabetes: Pancreatic Regeneration or Fetal Hyperinsulinism? | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2021-09-30T09:57:28Z | |
dc.description | This is the author accepted manuscript. The final version is available from the American Diabetes Association via the DOI in this record | en_GB |
dc.description | NOTE: the title of the author accepted manuscript in this record is slightly different from the final published version | en_GB |
dc.identifier.eissn | 1935-5548 | |
dc.identifier.journal | Diabetes Care | en_GB |
dc.rights.uri | http://www.rioxx.net/licenses/all-rights-reserved | en_GB |
dcterms.dateAccepted | 2021-04-27 | |
rioxxterms.version | AM | en_GB |
rioxxterms.licenseref.startdate | 2021-06-26 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2021-09-30T09:53:04Z | |
refterms.versionFCD | AM | |
refterms.dateFOA | 2021-09-30T09:57:41Z | |
refterms.panel | A | en_GB |