Healthy mums, healthy babies, healthy families

My research focuses on improving care for women and babies affected by diabetes in pregnancy, including type 1 diabetes, type 2 diabetes and gestational diabetes. Gestational diabetes is a form of diabetes which develops during pregnancy and which normally disappears after delivery of the baby. My research is supported by the Diabetes UK Harry Keen intermediate clinical fellowship and the Future leaders’ Award from the European Foundation for the Study of Diabetes in association with the Novo Nordisk Foundation. 

Women with diabetes have many challenges in pregnancy. Unfortunately, mothers with diabetes and their babies experience higher rates of pregnancy complications including excessive growth (large-for-gestational age), low blood glucose levels at birth (neonatal hypoglycaemia), or need neonatal intensive care unit (NICU) admission. Exposure to diabetes antenatally also influences the long-term health of the baby and increases their risks for obesity and diabetes.

My research aims to assess the impact of obesity, diet and weight change upon pregnancy outcomes in women with diabetes. I am also interested in how pregnancy events can influence the baby’s future health. I focus upon understanding the mechanisms of disease in diabetes in pregnancy, and the benefits of potential interventions in order to improve the health of women with diabetes in pregnancy and in later life, and the health of their children. I address this through the following specific aims:

Aim 1:   To understand why diabetes develops in pregnancy (pathophysiology)

Aim 2:   To find new interventions to improve outcomes in diabetes pregnancy, working towards healthier mums, healthier babies.

Aim 3:   To identify how health in pregnancy impacts upon long-term health in mothers and offspring, and how this could be addressed to prevent the inter-generational cycle of obesity.

Get involved

We are always interested to hear from people who would like to help us prioritise our research, think of new research questions, or contribute to the direction of our research group. We have a group of people who are particularly interested in diabetes in pregnancy who meet regularly (virtually or face-to-face) to help us focus on the most important research questions. If you are interested, please contact add-tr.digeststudy@nhs.net for more details.

Current studies

More information at www.diabetespregnancyresearch.co.uk

DiGest

A dietary intervention in gestational diabetes. This study is a randomised controlled trial of a reduced calorie diet in pregnant women with gestational diabetes. As excessive weight can cause problems during pregnancy, the aim of this study is to see if a reduction in the mother’s calorie intake can improve the health of mother and child both during and after pregnancy. As part of this study, pregnant mothers will receive 8-10 weeks of food which will be nutritionally balanced for pregnancy, designed for women with gestational diabetes and delivered straight to their door. This is a cutting-edge, novel approach to running a nutritional interventional study and should have exciting and clinically-relevant findings to help improve care for mothers with gestational diabetes.

OPHELIA

This is a 4-year observational study of pregnant mothers to help identify and explain the causes of gestational diabetes. Although most women with high sugar (glucose) levels first identified in pregnancy are diagnosed with gestational diabetes, it is likely that there are different underlying causes to this condition. A better understanding of those causes could improve care for women and their babies. As part of this study, pregnant women who are being tested for diabetes will be asked to give additional blood samples.

CONCEPTt

This was a large multicentre randomised controlled trial of the use of continuous glucose monitoring in women with type 1 diabetes in pregnancy. I am involved in analysing the data from CONCEPTt to understand better the biochemical and metabolic effects of diabetes in pregnancy and their consequences upon the growth of the baby.

Other activities

In addition to my research, I also work as a doctor, seeing patients with diabetes in pregnancy, and obesity at my clinics at Addenbrooke’s Hospital, Cambridge.

 

Selected publications

1. Furse S, Koulman A, Ozanne SE, Poston L, White SL, Meek CL. Altered Lipid Metabolism in Obese Women With Gestational Diabetes and Associations With Offspring Adiposity. J Clin Endocrinol Metab. 2022 Jun 16;107(7):e2825-e2832.
2. Jones D, De Lucia Rolfe E, Rennie KL, Griep LMO, Kusinski LC, Hughes DJ, Brage S, Ong KK, Beardsall K, Meek CL (2021). Antenatal Determinants of Childhood Obesity in High-Risk Offspring: Protocol for the DiGest Follow-Up Study. (2021) Nutrients. 13(4):1156.
3. Dennison RA, Griffin SJ, Usher-Smith JA, Fox RA, Aiken CE, Meek CL. “Post-GDM support would be really good for mothers”: A qualitative interview study exploring how to support a healthy diet and physical activity after gestational diabetes. PLoS One. 2022; 17(1):e0262852.
4. Meek CL, Oram RA, McDonald TJ, Feig DS, Hattersley AT, Murphy HR; CONCEPTT Collaborative Group. Reappearance of C-Peptide During the Third Trimester of Pregnancy in Type 1 Diabetes: Pancreatic Regeneration or Fetal Hyperinsulinism? Diabetes Care. (2021) doi: 10.2337/dc21-0028. Epub ahead of print. PMID: 34175829.
5. Napso T, Zhao X, Ibañez Lligoña M, Sandovici I, Kay RG, Gribble F, Reimann F, Meek CL, Hamilton RS, Sferruzzi-Perri AN. Placental secretome map identifies potential diagnostic and treatment targets for pregnancy complications. (2021) Nature Commun Biol. 4(1):701.
6. Meek CL,Tundidor D, Feig DS, Yamamoto JM, Scott EM, Ma DD, Halperin JA, Murphy HR, Corcoy R; CONCEPTT Collaborative Group. (2021) Novel Biochemical Markers of Glycemia to Predict Pregnancy Outcomes in Women With Type 1 Diabetes. Diabetes Care. 44(3):681-689.
7. Meek CL,Lindsay RS, Scott EM, et al. Approaches to screening for hyperglycaemia in pregnant women during and after the COVID-19 pandemic. (2020) Diabet Med. 38(1):e14380.
8. Kusinski LC, Murphy HR, De Lucia Rolfe E, Rennie KL, Oude Griep LM, Hughes D, Taylor R, Meek CL. Dietary Intervention in Pregnant Women with Gestational Diabetes; Protocol for the DiGest Randomised Controlled Trial. (2020) Nutrients. 12(4):1165.
9. Meek CL, Devoy B, Simmons D, Patient CJ, Murphy HR, Aiken CE. Seasonal variations in incidence and neonatal outcomes of gestational diabetes: a retrospective cohort study. (2020) Diabet Med. 37(4):674-680.
10. Feig DS, Donovan LE, Corcoy R, Murphy KE, Amiel SA, Hunt KF, Asztalos E, Barrett JFR, Sanchez JJ, de Leiva A, Hod M, Jovanovic L, Keely E, McManus R, Hutton EK, Meek CL,Stewart ZA, Wysocki T, O’Brien R, Ruedy K, Kollman C, Tomlinson G, Murphy HR; CONCEPTT Collaborative Group. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet 2017; 390 (10110); 2347 – 2359.