Awakened Beta-Cell Function Decreases the Risk of Hypoglycemia in Pregnant Women with Type 1 Diabetes Mellitus

J Clin Med. 2022 Feb 17;11(4):1050. doi: 10.3390/jcm11041050.

Abstract

Diabetes in pregnancy creates many problems for both the mother and child. Pregnant women with type 1 diabetes experience more frequent hypoglycemic and hyperglycemic episodes. This study aimed to determine the risk of clinically significant biochemical hypoglycemia (CSBH) by HbA1c, fasting C-peptide, mean plasma glucose (PG), and insulin dose in pregnant women type 1 diabetes mellitus according to each trimester of the pregnancy.

Methods: We conducted a prospective observational study of 84 pregnant women with type 1 diabetes in an academic hospital. To present the hypoglycemia, we divided the participants into two groups: those who did not have clinically significant biochemical hypoglycemia (CSBH-; n = 30) and those who had clinically significant biochemical hypoglycemia (CSBH+; n = 54).

Results: In the first, second, and third trimesters, the duration of T1DM, fasting C-peptide, and mean glucose concentration was inversely associated with CSBH.

Conclusions: Insulin overdose is the most common risk factor for hypoglycemia. In pregnant women with type 1 diabetes with elevated fasting C-peptide levels, the insulin dose should be diminished to reduce the risk of hypoglycemia.

Keywords: C-peptide; diabetes mellitus type 1; hypoglycemia; pregnancy.