ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2006) 11 P725

Outcomes of pregnancy and glycaemic control in patients with type 1 diabetes

N Asatiani1, R Kurashvili1, M Dundua1, E Shelestova2, K Pagava1, M Hod1, S Smirnov1 & V Vlasov3

1Georgian Diabetes Center, Tbilisi, Georgia; 2Dep.of Obstetrics and Gynecology, Rabin Medical Center, Tel-Aviv, Israel; 3Novo Nordisk A/S, Copenhagen, Denmark.

Background: It is generally believed that glycemic targets in diabetic pregnancies should mimic those found in normal pregnancies.

Aim: The aim of the present work was to reveal how glycemia indices in pregnant patients with type 1 diabetes mellitus (T1DM), their infants’ birth weight (IBW).

Methods: Totally, 128 pregnant women with T1DM were enrolled in the study (mean age – 26±7 yrs; diabetes duration – 10.2± 5.4 yrs). Patients with nephropathy were excluded. Strict metabolic control was maintained and fetal surveillance was performed throughout the pregnancy. Data obtained for home-blood glucose monitoring (five-point profiles), postprandial (PG), fasting (FG), mean blood glucose (MG) were enrolled in this work. Healthy infants were born to diabetic mothers at 38–40 week of gestation. According to the IBW, the patients were devided into 2 groups (GR): GR.1, n=97, IBW <4 000 g; Gr. 2, n=31, IBW >4 000 g.

Results: HbA1c, PG, FG and MG levels were statistically higher in GR.2, than in Gr.1: HbA1c (7.6±1.38% vs 5.6±1.71%, P<0.001), PG (168.1±17.1 vs 110.4±14.7, P=0.000), FG (136.5±15.8 vs 102.5±13.4, P=0.000), MG (155.2±12.17;vs 104.7±12.1, P=0.000). Pre-pregnancy BMI (kg/m2) indices were higher in GR.2, than in Gr.1 (27.2±0.58 vs 22.5±0.62, P<0.001).

Strong correlation was observed between IBW and PG (r−0.882; P=0.000), IBW and HbA1c (r−0.794; P=0.04), IBW and MG (r−0.703; P=0.012) for Gr.1, and between IBW and PG (r−0.814; P=0.000), IBW and pre-pregnancy BMI (r−0.866; P=0.001) for GR.2.

Summary: IBW strongly correlated with PG, MG and HbA1c in the pregnant patients with T1DM.

Pre-pregnancy BMI>26 kg/m2 and postprandial glycemia levels of >160 mg/dl may be the predictors of fetal macrosomia.

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