Glycaemic control throughout pregnancy and risk of pre‐eclampsia in women with type I diabetes

Temple, RC; Aldridge, V; Stanley, Katherine; Murphy, H

doi:10.1111/j.1471-0528.2006.01071.x

Cited by 60 publications

(70 citation statements)

References 13 publications

(27 reference statements)

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“…It has been postulated that longer duration of exposure of the placental vessels to a hyperglycemic and hypertensive environment is harmful (15,16). In one prospective study of 290 pregnant women with type 1 diabetes, an elevated A1C at 24 weeks' gestation was associated with a significantly higher risk of preeclampsia (17). However, as in our study, there are no data on glycemic control in pregnancy and the risk of preeclampsia and abruption or infarction.…”

Section: Discussioncontrasting

confidence: 52%

Prepregnancy Diabetes and Risk of Placental Vascular Disease

Becker

Vermeulen²,

Wyatt³

et al. 2007

Diabetes Care

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Section: Discussioncontrasting

confidence: 52%

Prepregnancy Diabetes and Risk of Placental Vascular Disease

Becker

Vermeulen²,

Wyatt³

et al. 2007

Diabetes Care

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“…In our study, frequency of preeclampsia was 33 %, which is almost 3 times more frequent than reported 12 % in other studies (11,12).…”

Section: Discussioncontrasting

confidence: 46%

Pregnancy and neonatal outcomes in women with type 1 diabetes mellitus

Durackova¹,

Krištúfková²,

Korbeľ³

2017

BLL

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AIM: The aim of study was to compare some perinatal outcomes in mothers with type 1 diabetes mellitus (T1DM). MATERIAL AND METHODS: All patients with T1DM delivered at the 1st Department of Obstetrics & Gynaecology of Faculty of Medicine, Comenius University in Bratislava from January 1st 2009 to December 31th 2015 were included to the study. RESULTS: Out of 118 diabetic mothers, 46.6 % had vasculopathy and 53. 4 % were without microvascular complications. In the vasculopathy group, signifi cantly higher incidence rates of preeclampsia (49. 1 versus 19.1 %; p = 0.002) and caesarean section (89.1 versus 68.3 %; p = 0.017) were found. Neonatal morbidity and mortality rates were higher in vasculopathy group (but not statistically signifi cantly). Preparation for pregnancy improves perinatal and neonatal results. Nevertheless, this preparation in our study group was received only in 9.3 %. Perinatal mortality was 25.4 per 1,000 total births. CONCLUSION: For pregnancy of diabetic women to become possible a qualifi ed management must be provided. Good outcomes for both women and newborns are real when preparation for pregnancy and metabolic control before and during whole pregnancy are at adequate level (Tab. 3, Ref. 28). Text in PDF www.elis.sk.

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“…Clearly, prepregnancy care plays an important role, improving early glycemic control and reducing major malformation and perinatal mortality (29). However, our recent data suggest that even the significant improvements in glycemic control achieved by women attending prepregnancy care are still "not good enough," in that they fail to reduce rates of preeclampsia and macrosomia (24,30). These complications are believed to be related to hyperglycemic excursions during the second and third trimesters (30,31), which are clearly demonstrated in this study.…”

Section: -Estimates Of Glycemic Characteristics For Women With Type 1mentioning

confidence: 61%

“…However, our recent data suggest that even the significant improvements in glycemic control achieved by women attending prepregnancy care are still "not good enough," in that they fail to reduce rates of preeclampsia and macrosomia (24,30). These complications are believed to be related to hyperglycemic excursions during the second and third trimesters (30,31), which are clearly demonstrated in this study. The majority of our subjects had nearoptimal glycemic control, attended prepregnancy care, and believed that wearing CGMS was beneficial (data not shown).…”

Section: -Estimates Of Glycemic Characteristics For Women With Type 1mentioning

confidence: 62%

Changes in the Glycemic Profiles of Women With Type 1 and Type 2 Diabetes During Pregnancy

et al. 2007

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OBJECTIVE -To examine the changes in glycemic excursions that occur during pregnancy using continuous glucose monitoring and to compare patterns of glycemia in pregnant women with type 1 and type 2 diabetes.RESEARCH DESIGN AND METHODS -An observational data analysis was performed from a prospective randomized study of continuous glucose monitoring in 57 women with pregestational type 1 (n ϭ 40) or type 2 (n ϭ 17) diabetes with 7-day continuous glucose monitoring system profiles during each trimester. Serial glucose measurements were divided into periods of euglycemia (70 -140 mg/dl), hyperglycemia (Ͼ140 mg/dl), and hypoglycemia (Ͻ70 mg/dl). Generalized linear mixed effects models were fitted to the repeated measures data to determine how these glycemic characteristics varied during gestation and by diabetes type.RESULTS -A total of 180 continuous glucose profiles were examined (140 type 1 diabetes, 40 type 2 diabetes), providing 20,433 h of data for analysis (16,117 h type 1 diabetes, 4,316 type 2 diabetes). Women with type 2 diabetes spend ϳ33% less time hyperglycemic throughout pregnancy than women with type 1 diabetes (P ϭ 0.005), with a significantly more rapid reduction in time spent hyperglycemic in early pregnancy (P ϭ 0.02). Although women with type 2 diabetes spend less overall time hypoglycemic (P ϭ 0.04), their risk of nocturnal hypoglycemia is equivalent to that of women with type 1 diabetes (blood glucose level Ͻ70 mg/dl, P ϭ 0.9; blood glucose level Ͻ50 mg/dl, P ϭ 0.2).CONCLUSIONS -Continuous glucose monitoring reveals clear differences in the level of glycemic control that exist in women with type 1 and type 2 diabetes. These data will guide therapeutic interventions aimed at optimizing glycemic control and improving the pregnancy outcomes of both type 1 and type 2 diabetes.

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Glycaemic control throughout pregnancy and risk of pre‐eclampsia in women with type I diabetes

Cited by 60 publications

References 13 publications

Prepregnancy Diabetes and Risk of Placental Vascular Disease

Prepregnancy Diabetes and Risk of Placental Vascular Disease

Pregnancy and neonatal outcomes in women with type 1 diabetes mellitus

Changes in the Glycemic Profiles of Women With Type 1 and Type 2 Diabetes During Pregnancy

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