Pregnant women with type 1 diabetes are at risk of giving birth prematurely
(Karolinska Institutet) Pregnant women with type 1 diabetes are at increased risk of delivering their baby prematurely. The risk increases as blood sugar levels rise, however women who maintain the recommended levels also risk giving birth prematurely. These are the findings from researchers at Karolinska Institutet and the Sahlgrenska Academy in Sweden, published in Annals of Internal Medicine.
Conclusions/interpretationMaternal obesity is associated with increased incidence of type 2 diabetes in the offspring. Evidence-based strategies that reduce obesity among women of reproductive age and that might reduce the incidence of diabetes in their offspring are urgently required.
The relationship between type 1 diabetes in pregnancy and adverse neonatal outcomes is well known [1 –3]. It is therefore recommended that all women of childbearing age with type 1 diabetes plan pregnancy in order to achieve optimal glycaemic control, evaluate diabetes-related complications and refresh their knowledge and skills about diabetes[4,5]. Prepregnancy care (PPC) has been associated wit h an 80% reduction of serious adverse pregnancy outcomes (major congenital malformation, stillbirth or neonatal death) and lower rates of very premature delivery[6–9].
CONCLUSION: Pregnancy provides an important opportunity for health professionals to educate and support women with pre-pregnancy diabetes about their breastfeeding intentions. PMID: 31239238 [PubMed - as supplied by publisher]
Breastfeeding has significant health benefits for maternal and infant health, yet women with pre-pregnancy diabetes (type 1 or type 2 diabetes mellitus) are often less likely to breastfeed compared with other childbearing women.
ConclusionThis case highlights that fulminant type 1 diabetes in pregnancy may be associated with Coxsackievirus B1 infection.
Guidelines address CGM goals for type 1 and type 2 diabetes, older/high-risk patients, and pregnant women with diabetes.Medscape Medical News
Care of pregnant mothers with type 1 diabetes and their newborns costs significantly less with use of continuous glucose monitoring than with conventional fingerprick testing, UK researchers said.Medscape News UK
Conclusions/interpretationHigher mean glucose levels, higher SD and less time in target range were associated with increased risk of LGA and NCO. Despite the use of CGM throughout pregnancy, the day-to-day glucose control was not optimal and the incidence of LGA remained high.
AbstractWith randomised trial data confirming that continuous glucose monitoring (CGM) is associated with improvements in maternal glucose control and neonatal health outcomes, CGM is increasingly used in antenatal care. Across pregnancy, the ambition is to increase the CGM time in range (TIR), while reducing time above range (TAR), time below range (TBR) and glycaemic variability measures. Pregnant women with type 1 diabetes currently spend, on average, 50% (12 h), 55% (13 h) and 60% (14 h) in the target range of 3.5–7.8 mmol/l (63–140 mg/dl) during the first, second and third trimest...
CONCLUSIONS: Two new studies (406 women) have been incorporated to one of the comparisons for this update. Although the evidence suggests that CGM in comparison to intermittent glucose monitoring may reduce hypertensive disorders of pregnancy, this did not translate into a clear reduction for pre-eclampsia, and so this result should be viewed with caution. No differences were observed for other primary outcomes for this comparison. The evidence base for the effectiveness of other monitoring techniques analysed in the other five comparisons is weak and based on mainly single studies with very low-quality evidence. Additiona...