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Plasma C‐peptide concentration in women with Type 1 diabetes during early and late pregnancy
Author(s) -
Murphy H. R.,
Elleri D.,
Allen J. M.,
Simmons D.,
Nodale M.,
Hovorka R.
Publication year - 2012
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2012.03747.x
Subject(s) - interquartile range , medicine , pregnancy , type 1 diabetes , endocrinology , c peptide , diabetes mellitus , meal , type 2 diabetes , carbohydrate , genetics , biology
Diabet. Med. 29, e361–e364 (2012) Abstract Aims There are previous suggestions of increased C‐peptide concentration in women with Type 1 diabetes during pregnancy. Our aim was to re‐evaluate the hypothesis of a pregnancy‐induced increase by measuring plasma C‐peptide concentration in women with stable blood glucose control under standardized fasting and meal‐stimulated conditions. Methods Ten women with Type 1 diabetes; median age 31.1 years, median diabetes duration 19 years, median HbA 1c 52 mmol/mol (6.9%) were admitted to a clinical research facility for two 24‐h visits in early (12–16 weeks) and late (28–32 weeks) pregnancy. Women They ate standardized study meals ‐ 80‐g carbohydrate dinner, 60‐g carbohydrate breakfast, and fasted between meals and overnight. Closed‐loop insulin delivery maintained stable and comparable glycaemic conditions. Paired samples for plasma glucose and C‐peptide were obtained. Results Plasma glucose levels were comparable in early (median 6.5 mmol/l; interquartile range 5.6–8.6) and late pregnancy (median 7.0 mmol/l; interquartile range 6.1–7.8; P = 0.72). There was no change in fasting or meal‐stimulated plasma C‐peptide concentration from early to late pregnancy; mean difference 4.0 pmol/l (95% CI −6.0 to 7.0; P = 0.9). Four women had detectable C‐peptide; peak (range) early vs. late pregnancy 48.5 (10–115) vs. 40.0 pmol/l (80–105); P = 0.5, which was weakly associated with plasma glucose; R 2 = 0.15, P < 0.0001. Conclusions We found no gestational changes in plasma C‐peptide concentration. Previously reported increases may reflect differences in glucose control and/or exogenous insulin doses. This study highlights the importance and challenges of standardizing experimental conditions for accurate plasma C‐peptide measurement during Type 1 diabetes pregnancy.