{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T13:32:28Z","timestamp":1780407148594,"version":"3.54.1"},"reference-count":32,"publisher":"American Diabetes Association","issue":"8","license":[{"start":{"date-parts":[[2021,6,26]],"date-time":"2021-06-26T00:00:00Z","timestamp":1624665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>We assessed longitudinal patterns of maternal C-peptide concentration to examine the hypothesis of \u03b2-cell regeneration in pregnancy with type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>C-peptide was measured on maternal serum samples from 127 participants (12, 24, and 34 weeks) and cord blood during the Continuous Glucose Monitoring in Women With Type 1 Diabetes in Pregnancy Trial (CONCEPTT). C-peptide was measured using a highly sensitive direct and solid-phase competitive electrochemiluminescent immunoassay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Three discrete patterns of maternal C-peptide trajectory were identified: pattern 1, undetectable throughout pregnancy, n = 74 (58%; maternal C-peptide &amp;lt;3 pmol\/L); pattern 2, detectable at baseline, n = 22 (17%; maternal C-peptide 7\u2013272 pmol\/L at baseline); and pattern 3, undetectable maternal C-peptide at 12 and 24 weeks, which first became detectable at 34 weeks, n = 31 (24%; maternal C-peptide 4\u201326 pmol\/L at 34 weeks). Baseline characteristics and third trimester glucose profiles of women with pattern 1 and pattern 3 C-peptide trajectories were similar, but women in pattern 3 had suboptimal glycemia (50% time above range) at 24 weeks\u2019 gestation. Offspring of women with pattern 3 C-peptide trajectories had elevated cord blood C-peptide (geometric mean 1,319 vs. 718 pmol\/L; P = 0.007), increased rates of large for gestational age (90% vs. 60%; P = 0.002), neonatal hypoglycemia (42% vs. 14%; P = 0.001), and neonatal intensive care admission (45% vs. 23%; P = 0.023) compared with pattern 1 offspring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>First maternal C-peptide appearance at 34 weeks was associated with midtrimester hyperglycemia, elevated cord blood C-peptide, and high rates of neonatal complications. This suggests transfer of C-peptide from fetal to maternal serum and is inconsistent with pregnancy-related \u03b2-cell regeneration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc21-0028","type":"journal-article","created":{"date-parts":[[2021,6,26]],"date-time":"2021-06-26T18:15:12Z","timestamp":1624731312000},"page":"1826-1834","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":14,"title":["Reappearance of C-Peptide During the Third Trimester of Pregnancy in Type 1 Diabetes: Pancreatic Regeneration or Fetal Hyperinsulinism?"],"prefix":"10.2337","volume":"44","clinical-trial-number":[{"clinical-trial-number":"nct01788527","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4176-8329","authenticated-orcid":false,"given":"Claire L.","family":"Meek","sequence":"first","affiliation":[{"name":"The Wellcome-MRC Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Addenbrooke\u2019s Hospital, Cambridge, U.K."},{"name":"Wolfson Diabetes and Endocrinology Clinic, Cambridge University Hospitals, Addenbrooke\u2019s Hospital, Cambridge, U.K."},{"name":"Department of Clinical Biochemistry, Cambridge University Hospitals, Addenbrooke\u2019s Hospital, Cambridge, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Oram","sequence":"additional","affiliation":[{"name":"Department of Diabetes Research, University of Exeter, Royal Devon and Exeter Hospital, Exeter, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Diabetes Research, University of Exeter, Royal Devon and Exeter Hospital, Exeter, U.K."},{"name":"Academic Department of Blood Sciences, Royal Devon and Exeter NHS Foundation Trust, Exeter, 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