Type-1 diabetes mellitus (T1DM) is caused by autoimmune insulitis. There are evidences that pregnancy and n-3 fatty acids exhibit suppressive effect on human inflammatory system.
Ninety pregnant women with T1DM were included in the prospective randomized placebo controlled clinical trial. Forty-seven of them were put on standard diabetic diet enriched with EPA and DHA twice a day (EPA 120 mg and DHA 616 mg; Study group) and 43 pregnant diabetic women were on standard diabetic diet with placebo (Control group). Duration of T1DM in all participants was between 5 to 30 years. Blood samples were analyzed from all pregnant women for fasting C-peptide (FC-peptide), fasting plasma glucose (FPG) and HbA1c in each trimester throughout pregnancy and after delivery. Umbilical vein blood was analyzed for fetal C-peptide level, glucose concentration and insulin resistance.
In the Study group FC-peptide concentration raised from 59.6±103.9 pmol/l in first trimester, to 67.7±101.3 pmol/l in the second trimester and to 95.1±152.7 pmol/l in the third trimester. Comparing the FC-peptide values during first and third trimester a statistically significant increase in third trimester was found (P<0.001). In the Control group FC-peptide concentration ranged from 41.7±91.6 pmol/l in the first trimester to 41.2±70.9 mmol/l in the second trimester while in the third trimester it reached 52.4±95.3 pmol/l. Comparing the FC-peptide values during first and third trimester the statistical difference was not significant.
Combining of LC n-3 PUFAs and pregnancy yields immunological tolerance and stimulates the production of endogenous insulin in women with T1DM.
Subscribe to Journal
Get full journal access for 1 year
only $9.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Delmis J, Radoncic E, Horvaticek M, Ivanisevic M . Dietary effect on C-peptide preservation in type 1 diabetic pregnant women. Gynaecol Perinatol 2015; 24: 31–36.
Djelmis J, Desoye G, Ivanisevic M (eds). Diabetology of Pregnancy. Karger: Basel, Switzerland, 2005.
Poole JA, Claman HN . Immunology of pregnancy: implications for the mother. Clin Rev Allergy Immunol 2004; 26: 161–170.
Wilder RL . Hormones, pregnancy, and autoimmune diseases. Ann N Y Acad Sci 1998; 840: 45–50.
Mayer-Davis EJ, Dabelea D, Crandell JL, Crume T, D'Agostino RB . Nutritional factors and preservation of C-peptide in youth with recently diagnosed type 1 diabetes. Diabetes Care 2013; 36: 1842–1850.
Stene LC, Joner G, Norwegian Childhood Diabetes Study Group. Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: a large, population-based, case-control study. Am J Clin Nutr 2003; 78: 1128–1134.
Adler AI, Boyko EJ, Schraer CD, Murphy NJ . Lower prevalence of impaired glucose tolerance and diabetes associated with daily seal oil or salmon consumption among Alaska natives. Diabetes Care 1994; 17: 1498–1501.
Nakamura T, Azuma A, Kuribayashi T, Sugihara H, Okuda S, Nakagawa M . Serum fatty acid levels, dietary style and coronary heart disease in three neighbouring areas in Japan: The Kumihama study. Br J Nutr 2003; 89: 267–272.
Norris JM, Yin X, Lamb MM, Barriga K, Seifert J, Hoffman M et al. Omega-3 polyunsaturated fatty acid intake and islet autoimmunity in children at increased risk for type 1 diabetes. JAMA 2007; 298: 1420–1428.
Stene LC, Ulriksen J, Magnus P, Joner G . Use of cod liver oil during pregnancy associated with lower risk of type I diabetes in the offspring. Diabetologia 2000; 43: 1093–1098.
Couet C, Delarue J, Ritz P, Antoine JM, Lamisse F . Effect of dietary fish oil on body fat mass and basal fat oxidation in healthy adults. Int J Obes Relat Metab Disord 1997; 21: 637–643.
Nielsen LR, Ekbom P, Damm P, Glümer Ch, Frandsen MM, Jensen DM et al. HbA1c Levels are significantly lower in early and late pregnancy. Diabetes Care 2004; 27: 1200–1201.
Nielsen LR, Damm P, Mathiesen ER . Improved pregnancy outcome in type 1 diabetic women with microalbuminuria or diabetic nephropathy effect of intensified antihypertensive therapy? Diabetes Care 2009; 32: 38–44.
Nielsen LR, Rehfeld JF, Pedersen-Bjergaard U, Damm P, Mathiesen ER . Pregnancy-induced rise in serum C-peptide concentrations in women with type 1 diabetes. Diabetes Care 2009; 32: 1052–1057.
Ringholm NL, Juul A, Pedersen-Bjergaard U, Thorsteinsson B, Damm P, Mathiesen ER . Lower levels of circulating IGF-I in type 1 diabetic women with frequent severe hypoglycaemia during pregnancy. Diabet Med 2008; 25: 826–833.
Delmis J, Drazancic A, Ivanisevic M, Suchanek E . Glucose, insulin, HGH and IGF-1 levels in maternal serum, amniotic fluid and umbilical venous serum. A comparison between late normal pregnancy and pregnancy complicated with diabetes and fetal growth retardation. J Perinat Med 1992; 20: 47–56.
Innis SM . Essential fatty acid transfer and fetal development. Placenta 2005; 26: S70–S75.
Storlien LH, Kraegen EW, Chisholm DJ, Ford GL, Bruce DG, Pascoe WS . Fish oil prevents insulin resistance induced by high-fat feeding in rats. Science 1987; 237: 885–888.
De Caterina R, Massaro M . Omega-3 fatty acids and the regulation of expression of endothelial proatherogenic and proinflammatory genes. J Membr Biol 2005; 206: 103–116.
This investigation was part of the scientific project approved by the Ministry of Science, Education and Technology of the Republic of Croatia, entitled Metabolic and Endocrine Changes in Pregnant Patients with Diabetes (No. 108-1080401-0386).
MH collected the samples and data analyses. JD did data analyses, statistical analyses and wrote the manuscript. MI revised/edited the manuscript. SO revised/edited the manuscript and approved it for submission. MH collected the samples.
The authors declare no conflict of interest.
About this article
Cite this article
Horvaticek, M., Djelmis, J., Ivanisevic, M. et al. Effect of eicosapentaenoic acid and docosahexaenoic acid supplementation on C-peptide preservation in pregnant women with type-1 diabetes: randomized placebo controlled clinical trial. Eur J Clin Nutr 71, 968–972 (2017). https://doi.org/10.1038/ejcn.2017.46