Glucose lowering and pre-eclampsia: the role of vascular function (v1)
Research type
Research Study
Full title
Diabetes, glucose lowering and pre-eclampsia prevention: the role of vascular function
IRAS ID
228052
Contact name
Sharon T Mackin
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Women who develop diabetes during pregnancy (gestational diabetes - GDM) are at increased risk of pre-eclampsia (PE), a condition associated with high blood pressure (BP) in pregnancy which can be fatal to mother and baby. Treatment of GDM, reduces risk of PE but we don't know why. Mothers with GDM have “stiffer” blood vessels that appear less able to contract and dilate to control BP. Whether glucose lowering improves that, the level that is most beneficial and whether specific diabetes treatments offer additional benefit remains unclear. Further whether these benefits are generally seen in maternal blood vessels or mainly apply in placental blood vessels is not known. We will test the hypotheses that glucose lowering improve measures of maternal and placental vascular function, and that metformin (a tablet used to lower glucose in pregnancy) will have additional benefits. We will recruit from the Princess Royal Maternity and Queen Elizabeth University Hospital Maternity Units in Glasgow. We will recruit 30 women diagnosed with GDM between 24-28 weeks of pregnancy, alongside 15 women with risk factors for GDM but normal blood glucose, and 15 women with neither risk factors nor GDM at a similar stage in pregnancy. Women will follow their routine care pathway which will be unaltered by the study. We will measure maternal vascular function non-invasively using ultrasound imaging of the main upper arm artery (Flow-mediated dilation)at 24-28 weeks and at three other points in the pregnancy. Bloods will be taken at 24 and 36 weeks to measure markers of vascular function. Placentas will also be collected at delivery, arteries from these dissected and artery reactivity measured. We will compare maternal and placental vascular function between those with GDM and those without, and assess how it changes over time in pregnancy. We will assess whether metformin provides additional benefit compared with insulin. Improved understanding of how diabetes treatment affects vascular function will allow better targeted prevention of PE.
REC name
South Central - Berkshire B Research Ethics Committee
REC reference
17/SC/0446
Date of REC Opinion
31 Aug 2017
REC opinion
Further Information Favourable Opinion