Is Pregnancy Outcome Worse in Type 2 Than in Type 1 Diabetic Women?

Hillman, Natalia; Herranz, Lucrecia; Vaquero, Pilar Martín; Villarroel, Africa; Fernández, Alberto; Pallardo, Luís Felipe

doi:10.2337/dc06-0680

Cited by 37 publications

(30 citation statements)

References 8 publications

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“…A recent meta-analysis study indicated that pregnant women with type 2 diabetes have a higher risk of perinatal mortality than those with type 1 diabetes [12]. However, others have reported that perinatal outcomes in women with type 2 diabetes are equally as poor as those for women with type 1 diabetes [13,14].…”

Section: Introductionmentioning

confidence: 98%

A comparison of pregnancy outcomes in Japanese women with type 2 and type 1 diabetes mellitus at tertiary centers

et al. 2011

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Aims/IntroductionThe global prevalence of type 2 diabetes has been increasing in all age groups in recent years. Some studies have suggested that perinatal outcomes in these women are worse than in women with type 1 diabetes. We evaluated pregnancy outcomes in Japanese women with type 2 and type 1 diabetes. Materials and methods We retrospectively studied 29 pregnancies in women with type 2 diabetes and 15 pregnancies in those with type 1 diabetes at two tertiary centers. The relationship between small for gestational age (SGA) and various other data was tested by correlation analysis. Results The amount of preconceptional care did not differ between the type 2 and type 1 diabetic women. Diabetic overt nephropathy was observed in 5 women with type 2 diabetes (17.2%) whereas none of the women with type 1 diabetes had this condition. The incidence of SGA in type 2 diabetes tended to be higher than in type 1 diabetes (24.1 and 6.7%).The incidence of SGA was higher than that of large for gestational age (LGA) in women with type 2 diabetes (24.1 and 10.3%). In correlation analysis, diabetic retinopathy and overt nephropathy significantly correlated with SGA. Conclusion We showed that pregnancy outcomes in type 2 diabetes were equally as poor as those in type 1 diabetes. We supposed that the high incidence of SGA in women with type 2 diabetes was associated with the high incidence of diabetic microvascular complications, especially diabetic overt nephropathy, which were related to poor preconceptional care.

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Section: Introductionmentioning

confidence: 98%

A comparison of pregnancy outcomes in Japanese women with type 2 and type 1 diabetes mellitus at tertiary centers

et al. 2011

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“…It is intriguing that although women with type 2 diabetes in this study spend 33% less time hyperglycemic, even during early pregnancy, large series confirm that their risks of congenital malformation and perinatal mortality are equivalent to those of type 1 diabetes. Some authors, based on A1C measurements, have concluded that congenital malformations in type 2 diabetes are unrelated to glycemic control (3). Whereas other well-documented factors such as poor pregnancy preparation, older age, and obesity clearly contribute to the poor outcomes in type 2 diabetic pregnancies, our data nonetheless suggest that during the critical stages of organogenesis, up to 8 weeks' gestation, women with type 2 diabetes are spending as much time hyperglycemic as those with type 1 diabetes (Fig.…”

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

confidence: 99%

“…It has also been shown that the outcomes of pregnancy in women with type 2 diabetes are at least as poor as for women with type 1 diabetes (1,(3)(4)(5)(6)(7)(8). Some studies, including our own regional audit, suggest that women with type 2 diabetes, who are older, more obese, and more likely to belong to an ethnic minority group, may have even poorer pregnancy outcomes than women with type 1 diabetes (5)(6)(7)9).…”

mentioning

confidence: 99%

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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“…3 The majority of women with diabetes, however, do not obtain PC and continue to have unplanned pregnancies. The majority of studies (Table 1) 4,5, [7][8][9][10][11][12][13][14][15][16][17][18][19] report that up to 62% of women with type 1 diabetes received PC, whereas < 36% of women with type 2 diabetes received PC. In studies by Gunton et al, 4,5 the rate of women with type 1 diabetes having received PC improved significantly over time (from 18.9 to 62.5%), but a downward trend was noted in the rate for women with type 2 diabetes (from 52.6 to 36.4%).…”

Section: Background and Clinical Problem: Preconception Counselingmentioning

confidence: 99%

Preconception Counseling and Type 2 Diabetes

Slocum¹

2007

Diabetes Spectrum

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Is Pregnancy Outcome Worse in Type 2 Than in Type 1 Diabetic Women?

Cited by 37 publications

References 8 publications

A comparison of pregnancy outcomes in Japanese women with type 2 and type 1 diabetes mellitus at tertiary centers

A comparison of pregnancy outcomes in Japanese women with type 2 and type 1 diabetes mellitus at tertiary centers

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

Preconception Counseling and Type 2 Diabetes

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