{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:22:29Z","timestamp":1793424149726,"version":"4.5.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000361","name":"Diabetes UK","doi-asserted-by":"publisher","award":["DUK-HKF 17\/0005712"],"award-info":[{"award-number":["DUK-HKF 17\/0005712"]}],"id":[{"id":"10.13039\/501100000361","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000361","name":"Diabetes UK","doi-asserted-by":"publisher","award":["PG 2017\/2278"],"award-info":[{"award-number":["PG 2017\/2278"]}],"id":[{"id":"10.13039\/501100000361","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diabetologia"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\/hypothesis<\/jats:title>\n                    <jats:p>Type 1 diabetes in pregnancy is associated with suboptimal pregnancy outcomes, attributed to maternal hyperglycaemia and offspring hyperinsulinism (quantifiable by cord blood C-peptide). We assessed metabolomic patterns associated with risk factors (maternal hyperglycaemia, diet, BMI, weight gain) and perinatal complications (pre-eclampsia, large for gestational age [LGA], neonatal hypoglycaemia, hyperinsulinism) in the Continuous Glucose Monitoring in Women with Type 1 Diabetes in Pregnancy Trial (CONCEPTT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 174 CONCEPTT participants gave \u22651 non-fasting serum sample for the biorepository at 12 gestational weeks (147 women), 24 weeks (167 women) and 34 weeks (160 women) with cord blood from 93 infants. Results from untargeted metabolite analysis (ultrahigh performance LC-MS) are presented as adjusted logistic\/linear regression of maternal and cord blood metabolites, risk factors and perinatal complications using a modified Bonferroni limit of significance for dependent variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Maternal continuous glucose monitoring time-above-range (but not BMI or excessive gestational weight gain) was associated with increased triacylglycerols in maternal blood and increased carnitines in cord blood. LGA, adiposity, neonatal hypoglycaemia and offspring hyperinsulinism showed distinct metabolite profiles. LGA was associated with increased carnitines, steroid hormones and lipid metabolites, predominantly in the third trimester. However, neonatal hypoglycaemia and offspring hyperinsulinism were both associated with metabolite changes from the first trimester, featuring triacylglycerols or dietary phenols. Pre-eclampsia was associated with increased abundance of phosphatidylethanolamines, a membrane phospholipid, at 24 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\/interpretation<\/jats:title>\n                    <jats:p>Altered lipid metabolism is a key pathophysiological feature of type 1 diabetes pregnancy. New strategies for optimising maternal diet and insulin dosing from the first trimester are needed to improve pregnancy outcomes in type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00125-023-05989-2","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:02:16Z","timestamp":1692835336000},"page":"2101-2116","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Metabolomic insights into maternal and neonatal complications in pregnancies affected by type 1 diabetes"],"prefix":"10.1007","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4176-8329","authenticated-orcid":false,"given":"Claire L.","family":"Meek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe A.","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denice S.","family":"Feig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4267-2051","authenticated-orcid":false,"given":"Samuel","family":"Furse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9387-7079","authenticated-orcid":false,"given":"Sandra L.","family":"Neoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9998-051X","authenticated-orcid":false,"given":"Albert","family":"Koulman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5489-0614","authenticated-orcid":false,"given":"Helen R.","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the CONCEPTT collaborative group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"issue":"3","key":"5989_CR1","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/S2213-8587(20)30406-X","volume":"9","author":"HR Murphy","year":"2021","unstructured":"Murphy HR, Howgate C, O\u2019Keefe J et al (2021) Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort study. Lancet Diabetes Endocrinol 9(3):153\u2013164. https:\/\/doi.org\/10.1016\/S2213-8587(20)30406-X","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"9","key":"5989_CR2","doi-asserted-by":"publisher","first-page":"1668","DOI":"10.1007\/s00125-017-4314-3","volume":"60","author":"HR Murphy","year":"2017","unstructured":"Murphy HR, Bell R, Cartwright C et al (2017) Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study. Diabetologia 60(9):1668\u20131677. https:\/\/doi.org\/10.1007\/s00125-017-4314-3","journal-title":"Diabetologia"},{"issue":"10110","key":"5989_CR3","doi-asserted-by":"publisher","first-page":"2347","DOI":"10.1016\/S0140-6736(17)32400-5","volume":"390","author":"DS Feig","year":"2017","unstructured":"Feig DS, Donovan LE, Corcoy R et al (2017) Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet 390(10110):2347\u20132359. https:\/\/doi.org\/10.1016\/S0140-6736(17)32400-5","journal-title":"Lancet"},{"issue":"8","key":"5989_CR4","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.2337\/dc18-0551","volume":"41","author":"RT McGrath","year":"2018","unstructured":"McGrath RT, Glastras SJ, Hocking SL, Fulcher GR (2018) Large-for-gestational-age neonates in type 1 diabetes and pregnancy: contribution of factors beyond hyperglycemia. Diabetes Care 41(8):1821\u20131828. https:\/\/doi.org\/10.2337\/dc18-0551","journal-title":"Diabetes Care"},{"key":"5989_CR5","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s12884-015-0452-0","volume":"15","author":"S Dzakpasu","year":"2015","unstructured":"Dzakpasu S, Fahey J, Kirby RS et al (2015) Contribution of prepregnancy body mass index and gestational weight gain to adverse neonatal outcomes: population attributable fractions for Canada. BMC Pregnancy Childbirth 15:21. https:\/\/doi.org\/10.1186\/s12884-015-0452-0","journal-title":"BMC Pregnancy Childbirth"},{"issue":"12","key":"5989_CR6","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1080\/14767058.2017.1322949","volume":"31","author":"M Grandy","year":"2018","unstructured":"Grandy M, Snowden JM, Boone-Heinonen J, Purnell JQ, Thornburg KL, Marshall NE (2018) Poorer maternal diet quality and increased birth weight. J Matern Fetal Neonatal Med 31(12):1613\u20131619. https:\/\/doi.org\/10.1080\/14767058.2017.1322949","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"8","key":"5989_CR7","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1002\/oby.22246","volume":"26","author":"LA Barbour","year":"2018","unstructured":"Barbour LA, Farabi SS, Friedman JE et al (2018) Postprandial triacylglycerols predict newborn fat more strongly than glucose in women with obesity in early pregnancy. Obesity (Silver Spring) 26(8):1347\u20131356. https:\/\/doi.org\/10.1002\/oby.22246","journal-title":"Obesity (Silver Spring)"},{"issue":"3","key":"5989_CR8","doi-asserted-by":"publisher","first-page":"681","DOI":"10.2337\/dc20-2360","volume":"44","author":"CL Meek","year":"2021","unstructured":"Meek CL, Tundidor D, Feig DS et al (2021) Novel biochemical markers of glycemia to predict pregnancy outcomes in women with type 1 diabetes. Diabetes Care 44(3):681\u2013689. https:\/\/doi.org\/10.2337\/dc20-2360","journal-title":"Diabetes Care"},{"issue":"5","key":"5989_CR9","doi-asserted-by":"publisher","first-page":"810","DOI":"10.2337\/dc18-2212","volume":"42","author":"GR Law","year":"2019","unstructured":"Law GR, Alnaji A, Alrefaii L et al (2019) Suboptimal nocturnal glucose control is associated with large for gestational age in treated gestational diabetes mellitus. Diabetes Care 42(5):810\u2013815. https:\/\/doi.org\/10.2337\/dc18-2212","journal-title":"Diabetes Care"},{"key":"5989_CR10","unstructured":"National Institute for Health and Care Excellence (2015) Diabetes in pregnancy: management from preconception to the postnatal period. NICE guideline NG3. Available from https:\/\/www.nice.org.uk\/guidance\/ng3"},{"issue":"8","key":"5989_CR11","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1111\/dme.13988","volume":"36","author":"JM Yamamoto","year":"2019","unstructured":"Yamamoto JM, Corcoy R, Donovan LE et al (2019) Maternal glycaemic control and risk of neonatal hypoglycaemia in type 1 diabetes pregnancy: a secondary analysis of the CONCEPTT trial. Diabet Med 36(8):1046\u20131053. https:\/\/doi.org\/10.1111\/dme.13988","journal-title":"Diabet Med"},{"issue":"1","key":"5989_CR12","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1111\/dme.14137","volume":"37","author":"JM Yamamoto","year":"2020","unstructured":"Yamamoto JM, Donovan LE, Mohammad K, Wood SL (2020) Severe neonatal hypoglycaemia and intrapartum glycaemic control in pregnancies complicated by type 1, type 2 and gestational diabetes. Diabet Med 37(1):138\u2013146. https:\/\/doi.org\/10.1111\/dme.14137","journal-title":"Diabet Med"},{"issue":"10","key":"5989_CR13","doi-asserted-by":"publisher","first-page":"2099","DOI":"10.1007\/s00125-016-4035-z","volume":"59","author":"M Persson","year":"2016","unstructured":"Persson M, Cnattingius S, Wikstrom AK, Johansson S (2016) Maternal overweight and obesity and risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes. Diabetologia 59(10):2099\u20132105. https:\/\/doi.org\/10.1007\/s00125-016-4035-z","journal-title":"Diabetologia"},{"issue":"11","key":"5989_CR14","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1111\/j.1471-0528.2006.01071.x","volume":"113","author":"RC Temple","year":"2006","unstructured":"Temple RC, Aldridge V, Stanley K, Murphy HR (2006) Glycaemic control throughout pregnancy and risk of pre-eclampsia in women with type I diabetes. BJOG 113(11):1329\u20131332. https:\/\/doi.org\/10.1111\/j.1471-0528.2006.01071.x","journal-title":"BJOG"},{"key":"5989_CR15","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz098","author":"U Sovio","year":"2019","unstructured":"Sovio U, McBride N, Wood AM et al (2019) 4-Hydroxyglutamate is a novel predictor of pre-eclampsia. Int J Epidemiol https:\/\/doi.org\/10.1093\/ije\/dyz098","journal-title":"Int J Epidemiol"},{"issue":"1","key":"5989_CR16","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s12884-021-03554-6","volume":"21","author":"CL Meek","year":"2021","unstructured":"Meek CL, Corcoy R, Asztalos E et al (2021) Which growth standards should be used to identify large- and small-for-gestational age infants of mothers with type 1 diabetes? A pre-specified analysis of the CONCEPTT trial. BMC Pregnancy Childbirth 21(1):96. https:\/\/doi.org\/10.1186\/s12884-021-03554-6","journal-title":"BMC Pregnancy Childbirth"},{"issue":"6","key":"5989_CR17","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1039\/c9mo00117d","volume":"15","author":"S Furse","year":"2019","unstructured":"Furse S, White SL, Meek CL et al (2019) Altered triacylglycerol and phospholipid metabolism predates the diagnosis of gestational diabetes in obese pregnancy. Mol Omics 15(6):420\u2013430. https:\/\/doi.org\/10.1039\/c9mo00117d","journal-title":"Mol Omics"},{"key":"5989_CR18","doi-asserted-by":"publisher","unstructured":"Meek CL (2023) CONCEPTT Metabolomics results 2023_03_17. Apollo - University of Cambridge Repository. https:\/\/doi.org\/10.17863\/CAM.95098.2","DOI":"10.17863\/CAM.95098.2"},{"issue":"5 Suppl","key":"5989_CR19","doi-asserted-by":"publisher","first-page":"1256s","DOI":"10.1093\/ajcn\/71.5.1256s","volume":"71","author":"NF Butte","year":"2000","unstructured":"Butte NF (2000) Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr 71(5 Suppl):1256s\u20131261s. https:\/\/doi.org\/10.1093\/ajcn\/71.5.1256s","journal-title":"Am J Clin Nutr"},{"issue":"6","key":"5989_CR20","doi-asserted-by":"publisher","first-page":"e1003102","DOI":"10.1371\/journal.pmed.1003102","volume":"17","author":"F Imamura","year":"2020","unstructured":"Imamura F, Fretts AM, Marklund M et al (2020) Fatty acids in the de novo lipogenesis pathway and incidence of type 2 diabetes: a pooled analysis of prospective cohort studies. PLoS Med 17(6):e1003102. https:\/\/doi.org\/10.1371\/journal.pmed.1003102","journal-title":"PLoS Med"},{"issue":"1","key":"5989_CR21","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1186\/s13059-018-1439-8","volume":"19","author":"FWB Sanders","year":"2018","unstructured":"Sanders FWB, Acharjee A, Walker C et al (2018) Hepatic steatosis risk is partly driven by increased de novo lipogenesis following carbohydrate consumption. Genome Biol 19(1):79. https:\/\/doi.org\/10.1186\/s13059-018-1439-8","journal-title":"Genome Biol"},{"issue":"4","key":"5989_CR22","doi-asserted-by":"publisher","first-page":"454","DOI":"10.3724\/zdxbyxb-2021-0261","volume":"50","author":"D Zhou","year":"2021","unstructured":"Zhou D, Ye M, Hu Z et al (2021) Screening of multiple acyl-CoA dehydrogenase deficiency in newborns and follow-up of patients. Zhejiang Da Xue Xue Bao Yi Xue Ban 50(4):454\u2013462. https:\/\/doi.org\/10.3724\/zdxbyxb-2021-0261","journal-title":"Zhejiang Da Xue Xue Bao Yi Xue Ban"},{"issue":"1","key":"5989_CR23","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1002\/jmd2.12162","volume":"56","author":"LL Crefcoeur","year":"2020","unstructured":"Crefcoeur LL, de Sain-van der Velden MGM, Ferdinandusse S et al (2020) Neonatal carnitine concentrations in relation to gestational age and weight. JIMD Rep 56(1):95\u2013104. https:\/\/doi.org\/10.1002\/jmd2.12162","journal-title":"JIMD Rep"},{"issue":"1","key":"5989_CR24","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1007\/s10545-008-1047-y","volume":"32","author":"JH Walter","year":"2009","unstructured":"Walter JH, Patterson A, Till J, Besley GT, Fleming G, Henderson MJ (2009) Bloodspot acylcarnitine and amino acid analysis in cord blood samples: efficacy and reference data from a large cohort study. J Inherit Metab Dis 32(1):95\u2013101. https:\/\/doi.org\/10.1007\/s10545-008-1047-y","journal-title":"J Inherit Metab Dis"},{"issue":"5","key":"5989_CR25","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/j.molmet.2015.03.004","volume":"4","author":"G Solinas","year":"2015","unstructured":"Solinas G, Bor\u00e9n J, Dulloo AG (2015) De novo lipogenesis in metabolic homeostasis: more friend than foe? Mol Metab 4(5):367\u2013377. https:\/\/doi.org\/10.1016\/j.molmet.2015.03.004","journal-title":"Mol Metab"},{"issue":"6","key":"5989_CR26","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1093\/ajcn\/74.6.737","volume":"74","author":"RM McDevitt","year":"2001","unstructured":"McDevitt RM, Bott SJ, Harding M, Coward WA, Bluck LJ, Prentice AM (2001) De novo lipogenesis during controlled overfeeding with sucrose or glucose in lean and obese women. Am J Clin Nutr 74(6):737\u2013746. https:\/\/doi.org\/10.1093\/ajcn\/74.6.737","journal-title":"Am J Clin Nutr"},{"key":"5989_CR27","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05198-1","author":"Y Liu","year":"2020","unstructured":"Liu Y, Kuang A, Talbot O et al (2020) Metabolomic and genetic associations with insulin resistance in pregnancy. Diabetologia. https:\/\/doi.org\/10.1007\/s00125-020-05198-1","journal-title":"Diabetologia"},{"issue":"3","key":"5989_CR28","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1007\/s00125-016-4182-2","volume":"60","author":"V Sandler","year":"2017","unstructured":"Sandler V, Reisetter AC, Bain JR et al (2017) Associations of maternal BMI and insulin resistance with the maternal metabolome and newborn outcomes. Diabetologia 60(3):518\u2013530. https:\/\/doi.org\/10.1007\/s00125-016-4182-2","journal-title":"Diabetologia"},{"issue":"2s","key":"5989_CR29","doi-asserted-by":"publisher","first-page":"S844","DOI":"10.1016\/j.ajog.2021.11.1356","volume":"226","author":"E Jung","year":"2022","unstructured":"Jung E, Romero R, Yeo L et al (2022) The etiology of preeclampsia. Am J Obstet Gynecol 226(2s):S844-s866. https:\/\/doi.org\/10.1016\/j.ajog.2021.11.1356","journal-title":"Am J Obstet Gynecol"},{"issue":"5","key":"5989_CR30","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1080\/19396368.2018.1482968","volume":"64","author":"MGBF Nobakht","year":"2018","unstructured":"Nobakht MGBF (2018) Application of metabolomics to preeclampsia diagnosis. Syst Biol Reprod Med 64(5):324\u2013339. https:\/\/doi.org\/10.1080\/19396368.2018.1482968","journal-title":"Syst Biol Reprod Med"},{"issue":"4","key":"5989_CR31","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1194\/jlr.P064451","volume":"57","author":"S Anand","year":"2016","unstructured":"Anand S, Young S, Esplin MS et al (2016) Detection and confirmation of serum lipid biomarkers for preeclampsia using direct infusion mass spectrometry. J Lipid Res 57(4):687\u2013696. https:\/\/doi.org\/10.1194\/jlr.P064451","journal-title":"J Lipid Res"},{"issue":"10","key":"5989_CR32","doi-asserted-by":"publisher","first-page":"e110747","DOI":"10.1371\/journal.pone.0110747","volume":"9","author":"HA Korkes","year":"2014","unstructured":"Korkes HA, Sass N, Moron AF et al (2014) Lipidomic assessment of plasma and placenta of women with early-onset preeclampsia. PLoS One 9(10):e110747. https:\/\/doi.org\/10.1371\/journal.pone.0110747","journal-title":"PLoS One"}],"container-title":["Diabetologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00125-023-05989-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00125-023-05989-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00125-023-05989-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T10:05:33Z","timestamp":1695981933000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00125-023-05989-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,24]]},"references-count":32,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["5989"],"URL":"https:\/\/doi.org\/10.1007\/s00125-023-05989-2","relation":{},"ISSN":["0012-186X","1432-0428"],"issn-type":[{"value":"0012-186X","type":"print"},{"value":"1432-0428","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,24]]},"assertion":[{"value":"30 March 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 August 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors would like to thank all the women with type 1 diabetes who participated in the CONCEPTT trial. We also acknowledge the invaluable support from the 31 clinical care teams and the CONCEPTT Steering Committee: D. S. Feig, H. R. Murphy, E. Asztalos, J. F. R. Barrett, R. Corcoy, A. de Leiva, L. E. Donovan, J. M. Hod, L. Jovanovic<sup>a<\/sup>, E. Keely, C. Kollman, R. McManus, K. E. Murphy, K. Ruedy and G. Tomlinson. For affiliations and other CONCEPTT contributors, see ESM Appendix\n                      \n                      . <sup>a<\/sup>Dr Lois Jovanovic died during the preparation of this manuscript.\u00a0Aspects of this study were presented in abstract form to the ADA Scientific sessions (2021; 2022), the Diabetes in Pregnancy Study Group (September 2021) and the EASD Annual Meeting (September 2021 and 2022). There are no overlapping manuscripts using this dataset in preparation, submitted or published.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"The data that support the findings of this study are available on request from the CONCEPTT trial steering committee via senior author HRM (Helen.Murphy@uea.ac.uk). The data are not publicly available as they contain information that could compromise research participant privacy\/consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"This project was funded by Diabetes UK (PG 2017\/2278). The CONCEPTT trial was funded by JDRF grants #17\u20102011\u2010533, and grants under the JDRF Canadian Clinical Trial Network, a public\u2013private partnership including JDRF and FedDev Ontario and supported by JDRF #80\u20102010\u2010585. Medtronic supplied the CGM sensors and CGM systems at reduced cost. The study sponsor\/funders were not involved in the design of the study; the collection, analysis and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report.\u00a0CLM is supported by the Diabetes UK Harry Keen Intermediate Clinical Fellowship (DUK-HKF 17\/0005712), a BMA Foundation Award (Helen H. Lawson Award) and the European Foundation for the Study of Diabetes \u2013 Novo Nordisk Foundation Future Leaders\u2019 Award (NNF19SA058974). HRM conducts independent research supported by the National Institute for Health and Care Research (NIHR) (Career Development Fellowship, CDF-2013-06-035) and is supported by Tommy\u2019s charity. SF and AK acknowledge funding from the BBSRC (BB\/M027252\/1). DSF conducts independent research supported by the Canadian Institute for Health Research.\u00a0This research was supported by the NIHR Cambridge BRC, the core biochemical assay laboratory (CBAL) and the core metabolomic and lipidomic laboratory (CMAL). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"HRM is a member of the editorial board of Diabetologia. HRM has received honoraria for speaking engagements from Medtronic, Roche, Novo Nordisk, Eli-Lilly and is a member of the Medtronic European Advisory Board. CLM has received research support from Dexcom Inc. DSF is a member of the Novo Nordisk Expert Panel for the EXPECT trial and has received honoraria for speaking engagements from Medtronic. All other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their contribution to this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"CLM contributed to study design and formulated the data analysis plan, analysed and interpreted the data, made figures and tables, wrote and revised the manuscript. ZAS applied for funding, arranged the laboratory analyses and contributed to manuscript revisions. SLN collected dietary data, read and revised the final manuscript. SF and DSF contributed to data interpretation, manuscript writing and revisions. AK analysed and interpreted the data and reviewed and revised the manuscript. HRM contributed to study design, data interpretation and reviewed and revised the manuscript. All authors gave approval of the final version of the manuscript prior to publication. CLM is the guarantor of this work and, as such, has had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}