ECE2022 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (202 abstracts)
The relationship between clinically significant neonatal hypoglycemia and cord blood c-peptide levels in neonates of mothers with type 1 diabetes
Genya Aharon-Hananel 1,2 , Keren Levi 1 , Rina Hemi 3 , Ehud Barhod 3 , Oshrit Kordi-Patimer 3 , Shali Mazaki-Tovi 2,4 , Rakefet Yoeli-Ullman 2,4 & Tali Cukierman-Yaffe 1,5
1The Chaim Sheba Medical Center, Tel Hashomer, Division of Endocrinology, Diabetes and Metabolism, Ramat Gan, Israel; 2Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel; 3Chaim Sheba Medical Center, Tel-Hashomer, Israel, Endocrine Laboratory, Division of Endocrinology, Diabetes and Metabolism, Ramat Gan, Israel; 4Sheba Medical Center, Tel-Hashomer, Department of Obstetrics and Gynecology, Israel; 5Tel Aviv University, Epidemiology D., Sackler School of Medicine, Tel Aviv, Israel
Introduction: Neonate of patients with type I diabetes (T1D) are at increased risk for neonatal hypoglycemia. It is hypothesized that this is a result of maternal hyperglycemia and subsequent fetal hyperinsulinemia.
Aim: The aim of this study was to determine the relationship between clinically significant neonatal hypoglycemia (CS-hypo) and cord-blood c-peptide (CBCP) concentrations in patients with T1D.
Materials and methods: This was a prospective cohort study including patients with T1D followed at a single tertiary center. Clinical variables and glucose control data during pregnancy were prospectively recorded. Cord-blood of neonates was collected, and CBCP concentration was determined. The correlation between CS-hypo (neonatal hypoglycemia requiring IV glucose treatment) and CBCP concentrations was determined.
Results: This analysis pertains to 54 pregnancies. Mothers to neonates that experienced CS-hypo had longer diabetes duration (19 vs. 13 years, P=0.023), higher HbA1c at conception (7.3 [6.3–8.8] vs. 6.5 [6.0–7.0], P=0.042) and higher rates of caesarian section (73.3% vs. 28.2%, P=0.005) than mothers to neonates who did not. No differences were observed between the groups in BMI, age, and other maternal complications, nor in glucose control indices (Table 1). CBCP levels were significantly higher in neonates with CS-hypo than in those who did not (3.3 mg/l vs 1.9 mg/l, P=0.002). After adjustment for age at conception, BMI, diabetes duration, neonatal birth weight and 3rdtrimester HbA1c, every 1 unit higher in CBCP level was associated with a 1.46 (1.02–2.09, P=0.035) fold greater risk CS-hypo.
| Neonatal – CS-hypo | No neonatal CS-hypo | P for comparison | Total | |
| Maternal Age (Median, [IQR]) | 30.0 [26.0–34.0] | 29.0 [25.7–35.2] | 0.905 | |
| BMI (Median, [IQR]) | 23.1 [21.2–30.1] | 25.4 [23.1–27.8] | 0.333 | |
| Duration of T1D (Median, [IQR]) | 19.0 [13.0–23.0] | 14 [9.5–18.0] | 0.023* | |
| A1C at conception (Median, [IQR]) | 7.3 [6.3–8.8] | 6.5 [6.0–7.0] | 0.042* | |
| A1c at 1st trimester (Median, [IQR]) | 6.7 [5.5–7.3] | 5.9 [5.5–6.4] | 0.136 | |
| A1c at 2 nd trimester (Median, [IQR]) | 5.8 [5.2–6.1] | 5.5 [5.2–6.0] | 0.347 | |
| A1c at 3rd trimester (Median, [IQR]) | 5.7 [5.3–6.0] | 5.7 [5.3–6.1] | 0.969 | |
| Mean average blood-glucose (Median, [IQR]) | 126 [119.7–156.7] | 127 [111.5–138-3] | 0.591 | |
| Mean average glucose-Sensor (Median, [IQR]) | 118.0 [103.1–130.6] | 115 [106.7–126.4] | 0.785 | |
| PET (Number, [%]) | 3 [20.0] | 2 [5.1] | 0.124 | 5 [9.3%] |
| Cesarian section (Number, [%]) | 11 [73.3] | 11 [28.2] | 0.005* | 22 [40.7%] |
| Preterm delivery (Number, [%]) | 6 [40.0] | 6 [15.4] | 0.06 | 12 [22.2%] |
| LGA (Number, [%]) | 0 [0.0] | 3 [7.7] | 0.5 | 3 [5.6%] |
Conclusion: In neonates of patients with T1D, higher CBCP levels are associated with a higher risk for neonatal hypoglycemia.
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Endocrine Abstracts
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