Background: Several studies have shown that the over activation of complement factor B(CFB) was related to obesity, insulin resistance(IR) and type 2 diabetes mellitus. This study was to assess whether circulating complement factor Ba (CFBa) within 11 to 17 weeks of gestation is associated with subsequent gestational diabetes mellitus (GDM) or not.Methods: Biochemical parameters and blood samples were collected from 399 pregnant women within 11 to 17 weeks of gestation. At 24 to 28 weeks of pregnancy, all participants underwent 75-g oral glucose tolerance test (fasting for more than 8 hours before blood sampling) and were assigned to GDM group(n=80) and normal control group(n=319). Perinatal data were collected after delivery. A propensity score-matched (PSM) analysis was performed to reduce the impact of confounding factors on glucose metabolism during pregnancy between the two groups.Results: Two groups of 74 well-matched patients who maintained balance in terms of baseline characteristics. The levels of CFBa in pregnant women who later developed GDM were significantly higher than those in healthy pregnant women [0.4(0.1-0.8) vs. 0.2(0.2-0.3), P=0.031]. Logistic regression results confirmed that the level of CFBa was an independent influencing factor for the occurrence of GDM (OR=1.52, 95% CI: 1.25-1.85, P=0.000). Further grouping according to the quartile of CFBa level, it was found that the incidence of GDM in category 3 was markedly higher than that in the first and the second categories. Conclusions: High level of the CFBa within 11 to 17 weeks of gestation increased the risk of subsequent GDM, and maybe a biomarker for predicting GDM.

Aims: Hypoglycemia is an acute complication of patients with type 1 diabetes. This study investigated flash glucose monitoring in hypoglycemia monitor in patients with type 1 diabetes. Methods: A total of 120 patients with type 1 diabetes were recruited and randomly divided to implement FreeStyle LibreTM as flash glucose monitoring group (n=60) and retrospective continuous glucose monitoring system (CGMS) as control group (n=60). Both groups carried out CGMS at least two times a year and filled three questionnaires including Diabetes Monitoring and Treatment Satisfaction Questionnaire (DMTSQ), Diabetes Specific Quality of Life (DQoL) and Chinese Version Hypoglycemia Fear Survey II (CFH II). Clinical Data, CGM metrics and Questionnaire scores were collected at first visit and one year follow up. Results: The result showed that the time below range (TBR) and the glucose coefficient of variation (CV) were significantly higher in flash glucose monitoring group than control group (all P <0.05). TBR was prolonged with the increase of CV (P <0.05) and low blood glucose index (LBGI) (P <0.05) in both two groups. After multiple stepwise linear regression, CV and LBGI were independent risk factors for TBR (Standardized Coefficients β=0.665, β=0.762, respectively, All P<0.001 ). After one year followed up, the scores of DQoL and DMTSQ had no significant difference, but number of hypoglycemia times per month and scores of behavior part of CFH II significantly decreased in flash glucose monitoring group compared with a year ago (all P<0.05). Conclusions: Glucose CV and LBGI were independent risk factors for TBR. And Flash glucose monitoring decreased number of hypoglycemia times per month and fear behavior of hypoglycemia in patients with type 1 diabetes after one year. Disclosure J. Li: None. F. Liu: None. Funding National Key Research and Development Program of China (2017YFC1309601)

Purpose: To explore a new mechanism of improving glucose homeostasis in pregnancy through activation of Takeda G protein-coupled receptor 5 (TGR5) in bone marrow derived macrophages (BMDM) from gestational diabetes mellitus (GDM) model mouse and observation the changes of macrophages migration, inflammatory factors and chemokines expression and secretion, and the expression of Proprotein Convertase 1/3 (PC1/3). Methods: INT-777 was used as TGR5 agonist and LPS was used as inducer for macrophage polarization to M1. Primary bone marrow cells were extracted from GDM model mouse and were induced into macrophages. The macrophages activity and migration were detected by cck-8 tests and Transwell assay respectively when macrophages were treated with INT-777. The expression and secretion levels of inflammatory factors and chemokines in macrophages were detected by real-time PCR, cytometric bead array and ELISA, and the expression levels of PC1/3 was detected by Western blot when macrophages were treated both with INT-777 and lipopolysaccharide (LPS). Results: TGR5 activation of macrophages by INT-777 increased cell activity (P < 0.01) and decreased cell migration (P < 0.001). Moreover, the mRNA levels of inflammatory cytokines and chemokines including IL-1β, IL-6, TNF-α, CCL2, CCL4, CCL5 and CCL7 mRNA were significantly decreased (All P < 0.05), the secretion levels of inflammatory cytokines and chemokines including IL-6, TNF-α, MCP-1, CCL2, CCL3 and CCL4 were significantly decreased (All P < 0.05) and the expression of PC1/3 was increased (P < 0.05) in INT-777 + LPS treated macrophages, compared with LPS treated macrophages only. Conclusions: Activation of TGR5 in BMDM can effectively inhibit the macrophage polarization to M1, including inhibiting inflammatory factors expression and secretion. Moreover, activation of TGR5 can inhibit macrophage chemokine expression and secretion, cell migration and can upregulate PC1/3 expression. Disclosure J. Li: None. F. Liu: None. Funding National Natural Science Foundation of China (81770802)