Our aim was to evaluate the efficacy of a structured outpatient education and treatment program (SOETP) in type 1 diabetes patients (T1DM) patients during preconception care (PC) and pregnancy, and its effect on pregnancy outcomes. Study Methods: In total 173 women with T1DM were supervised. Maternal age was 28±8 yrs and diabetes duration - 12±7yrs. SOETP combined group and individual training. Stage 1 - preconception care (group and individual training). Stage 2 - individual education once per week throughout the pregnancy; group discussion once per month. SOETP included: diabetes physiology in pregnancy, managing hypoglycemia, diet, insulin therapy, glucose self-monitoring, relaxation, exercise, non-stress tests and diabetes complications. Specific Knowledge Assessment Questionnaire (65 questions) was completed by all patients pre- and post-program.
Gr. 1 - 88 women went through Stage 1 and 2; Gr. 2 - 85 women - only through Stage 2. Results. At conception women from Gr. 1 were well-controlled (HbA1c - 6.0 (0.31)%, postprandial glycemia - 142.2 (10.6)mg/dl), though HbA1c and PPG levels in women from Gr. 2 were statistically higher (8.4 (0.51)%, P=0.000; 184.8 (13.3) mg/dl, P=0.000 respectively). By the end of the 1st trimester those indices dropped. All patients were tested to evaluate knowledge. At entry number of correct answers was very low (28%); post-program scores were significantly higher (96%). Spontaneus abortions were revealed in 2.2% (Gr. 1) vs 5.8% (Gr. 2); preeclampsia- in 6.8% (Gr. 1) vs 14.1% (Gr. 2); perinatal mortality - in 1.1%(Gr. 1) vs 3.5% (Gr. 2).
SOETP may be effectively used for T1DM patient education during PC and pregnancy; it significantly reduced rates of spontaneous abortion rates, mortality and morbidity.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
05 - 09 May 2012
European Society of Endocrinology