(03-08-12) Plasma C-peptide concentration in women with Type 1 diabetes during early and late pregnancy.

Murphy HR, Elleri D, Allen JM, Simmons D, Nodale M, Hovorka R.
Source
University of Cambridge Metabolic Research Laboratories and NIHR Cambridge
Biomedical Research Centre, Institute of Metabolic Science, Addenbrooke's
Hospital Department of Paediatrics, University of Cambridge and Cambridge
University Hospitals NHS Foundation Trust, Institute of Metabolic Science,
Cambridge, UK.
Abstract
 Aims: There are previous suggestions of increased C-peptide concentration in
women 1 diabetes during pregnancy. Our aim was to re-evaluate the with Type
hypothesis of a pregnancy-induced increase by measuring plasma C-peptide
concentration in women with stable blood glucose control under standardized
Ten women with Type 1 fasting and meal-stimulated conditions. Methods:
years, mean HbA(1c) years, mean diabetes duration 19 diabetes; mean age 31.1  52
mmol/mol (6.9%) were admitted to a clinical research facility for two 24-h
weeks) pregnancy. They weeks) and late (28-32 visits in early (12-16 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 plasma glucose and C-peptide were obtained. Results: glucose levels
mmol/l; interquartile were comparable in early (median 6.5 range 5.6-8.6) and
mmol/l; interquartile range late pregnancy (median 7.0 0.72). = 6.1-7.8; P
There was no change in fasting or meal-stimulated plasma C-peptide
concentration from early to late pregnancy; mean difference CI pmol/l (95% 4.0
0.9). Four women had detectable = -6.0 to 7.0; P C-peptide; peak (range) early
vs. late pregnancy 48.5 (10-115) vs. 0.5, which was = pmol/l (80-105); P 40.0
weakly associated with plasma  0.15, P = glucose; R(2) < 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
1 diabetes during Type pregnancy. ? 2012 The Authors. Diabetic Medicine ? 2012
Diabetes UK.
? 2012 The Authors. Diabetic Medicine ? 2012 Diabetes UK.


Source: Diabet Med. 2012 Jul 18. doi: 10.1111/j.1464-5491.2012.03747.x. [Epub ahead of
print]

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