Severe hypoglycaemia during pregnancy in women with type 1 diabetes: possible role of renin-angiotensin system activity?

L Ringholm Nielsen; U Pedersen-Bjergaard; B Thorsteinsson; F Boomsma; P Damm; E R Mathiesen; L Ringholm Nielsen; U Pedersen-Bjergaard; B Thorsteinsson; F Boomsma; P Damm; E R Mathiesen

doi:10.1016/j.diabres.2009.01.006

Severe hypoglycaemia during pregnancy in women with type 1 diabetes: possible role of renin-angiotensin system activity?

L Ringholm Nielsen, U Pedersen-Bjergaard, B Thorsteinsson, F Boomsma, P Damm, E R Mathiesen, L Ringholm Nielsen, U Pedersen-Bjergaard, B Thorsteinsson, F Boomsma, P Damm, E R Mathiesen

11 Citations (Scopus)

Abstract

AIMS: To investigate whether increased risk of severe hypoglycaemia in early pregnancy is related to pregnancy-induced changes in renin-angiotensin system (RAS) activity in women with type 1 diabetes (T1DM). METHODS: Severe hypoglycaemic events the year preceding pregnancy were recorded retrospectively in 107 consecutive pregnant women with T1DM. Events during pregnancy were recorded prospectively. Measurements of ACE, renin and angiotensinogen were determined at 8, 14, 21, 27 and 33 weeks and postpartum. RESULTS: The rate of severe hypoglycaemia was 1.1 and 5.3 events/patient-year the year preceding pregnancy and in first trimester, respectively (p<0.0001). Levels of ACE, renin or angiotensinogen did not differ between women with and without severe hypoglycaemia during pregnancy. Multivariate regression analysis identified a positive association between rate of severe hypoglycaemia the year preceding pregnancy and postpartum ACE activity (relative rate of severe hypoglycaemia above versus below median ACE activity: 4.4 (CI: 1.7-11.9), p=0.003). No association was found between severe hypoglycaemia during pregnancy and renin angiotensin system activity at 8 weeks. CONCLUSIONS: In early pregnancy increased RAS activity does not explain the 5-fold increase in severe hypoglycaemia in women with T1DM. A positive association between occurrence of severe hypoglycaemia and ACE activity outside pregnancy was demonstrated.

Original language	English
Journal	Diabetes Research and Clinical Practice
Volume	84
Issue number	1
Pages (from-to)	61-7
Number of pages	6
ISSN	0168-8227
DOIs	https://doi.org/10.1016/j.diabres.2009.01.006 https://doi.org/10.1016/j.diabres.2009.01.006
Publication status	Published - 2009

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Nielsen, L. R., Pedersen-Bjergaard, U., Thorsteinsson, B., Boomsma, F., Damm, P., Mathiesen, E. R., Nielsen, L. R., Pedersen-Bjergaard, U., Thorsteinsson, B., Boomsma, F., Damm, P., & Mathiesen, E. R. (2009). Severe hypoglycaemia during pregnancy in women with type 1 diabetes: possible role of renin-angiotensin system activity? Diabetes Research and Clinical Practice, 84(1), 61-7. https://doi.org/10.1016/j.diabres.2009.01.006, https://doi.org/10.1016/j.diabres.2009.01.006

Nielsen, LR, Pedersen-Bjergaard, U, Thorsteinsson, B, Boomsma, F, Damm, P , Mathiesen, ER, Nielsen, LR, Pedersen-Bjergaard, U, Thorsteinsson, B, Boomsma, F, Damm, P & Mathiesen, ER 2009, 'Severe hypoglycaemia during pregnancy in women with type 1 diabetes: possible role of renin-angiotensin system activity?', Diabetes Research and Clinical Practice, vol. 84, no. 1, pp. 61-7. https://doi.org/10.1016/j.diabres.2009.01.006, https://doi.org/10.1016/j.diabres.2009.01.006

@article{06cb51e0584511df928f000ea68e967b,

title = "Severe hypoglycaemia during pregnancy in women with type 1 diabetes: possible role of renin-angiotensin system activity?",

abstract = "AIMS: To investigate whether increased risk of severe hypoglycaemia in early pregnancy is related to pregnancy-induced changes in renin-angiotensin system (RAS) activity in women with type 1 diabetes (T1DM). METHODS: Severe hypoglycaemic events the year preceding pregnancy were recorded retrospectively in 107 consecutive pregnant women with T1DM. Events during pregnancy were recorded prospectively. Measurements of ACE, renin and angiotensinogen were determined at 8, 14, 21, 27 and 33 weeks and postpartum. RESULTS: The rate of severe hypoglycaemia was 1.1 and 5.3 events/patient-year the year preceding pregnancy and in first trimester, respectively (p<0.0001). Levels of ACE, renin or angiotensinogen did not differ between women with and without severe hypoglycaemia during pregnancy. Multivariate regression analysis identified a positive association between rate of severe hypoglycaemia the year preceding pregnancy and postpartum ACE activity (relative rate of severe hypoglycaemia above versus below median ACE activity: 4.4 (CI: 1.7-11.9), p=0.003). No association was found between severe hypoglycaemia during pregnancy and renin angiotensin system activity at 8 weeks. CONCLUSIONS: In early pregnancy increased RAS activity does not explain the 5-fold increase in severe hypoglycaemia in women with T1DM. A positive association between occurrence of severe hypoglycaemia and ACE activity outside pregnancy was demonstrated.",

author = "Nielsen, {L Ringholm} and U Pedersen-Bjergaard and B Thorsteinsson and F Boomsma and P Damm and Mathiesen, {E R} and Nielsen, {L Ringholm} and U Pedersen-Bjergaard and B Thorsteinsson and F Boomsma and P Damm and Mathiesen, {E R}",

note = "Keywords: Adult; Angiotensinogen; Case-Control Studies; Diabetes Mellitus, Type 1; Female; Humans; Hypoglycemia; Peptidyl-Dipeptidase A; Pregnancy; Pregnancy Complications; Renin; Renin-Angiotensin System",

year = "2009",

doi = "10.1016/j.diabres.2009.01.006",

language = "English",

volume = "84",

pages = "61--7",

journal = "Diabetes Research and Clinical Practice",

issn = "0168-8227",