Journal
PHARMACEUTICS
Volume 13, Issue 12, Pages -Publisher
MDPI
DOI: 10.3390/pharmaceutics13122082
Keywords
pregnancy; type 1 diabetes mellitus; beta-cell; insulin; C-peptide; hypoglycemia; n-3 PUFA; placenta; fetus
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Funding
- CROATIAN SCIENCE FOUNDATION [IP-2018-01-1284]
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Pregnancy in women with type 1 diabetes results in a partial decrease in immune system activity, leading to improved insulin production and enlargement of Langerhans islets. N-3 polyunsaturated fatty acids play a protective role and aid in increasing C-peptide levels during pregnancy.
Type 1 diabetes (T1DM) is an autoimmune disease characterized by the gradual loss of beta-cell function and insulin secretion. In pregnant women with T1DM, endogenous insulin production is absent or minimal, and exogenous insulin is required to control glycemia and prevent ketoacidosis. During pregnancy, there is a partial decrease in the activity of the immune system, and there is a suppression of autoimmune diseases. These changes in pregnant women with T1DM are reflected by Langerhans islet enlargement and improved function compared to pre-pregnancy conditions. N-3 polyunsaturated fatty acids (n-3 PUFA) have a protective effect, affect beta-cell preservation, and increase endogenous insulin production. Increased endogenous insulin production results in reduced daily insulin doses, better metabolic control, and adverse effects of insulin therapy, primarily hypoglycemia. Hypoglycemia affects most pregnant women with T1DM and is several times more common than that outside of pregnancy. Strict glycemic control improves the outcome of pregnancy but increases the risk of hypoglycemia and causes maternal complications, including coma and convulsions. The suppression of the immune system during pregnancy increases the concentration of C-peptide in women with T1DM, and n-3 PUFA supplements serve as the additional support for a rise in C-peptide levels through its anti-inflammatory action.
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