In a nutshell
This study investigated blood glucose control in the second and third trimesters and pregnancy outcomes in women with type 1 diabetes. The authors concluded that regular testing of average blood glucose levels could be beneficial, as higher levels were associated with adverse outcomes.
Some background
Patients with type 1 diabetes (T1D) do produce enough insulin (the hormone needed to break down the glucose taken in from food. During pregnancy, women with uncontrolled blood sugar levels are at a higher risk of adverse outcomes for both mother and baby. Larger newborn size is one possible outcome. Excessively large babies, for example, can have an increased risk of obesity and diabetes. It is currently recommended that women try to achieve HbA1c levels (average blood glucose over 3 months) under 6% during the first trimester. It is not clear whether this should be the same target in the second or third trimesters.
Methods & findings
This study included 725 pregnant women with T1D. HbA1c levels were measured at 26 and 34 weeks. Patients were followed to determine the outcomes of both the mother and the baby following birth.
At 26 weeks of pregnancy, patients with an HbA1c between 6.0% and 6.4% were 70% more likely to have babies who were large at birth. Patients with levels between 6.5 and 6.9% at 26 weeks were over twice as likely to give birth prematurely, to have a baby requiring sugar infusion at birth, or a combination of other adverse outcomes. These results were similar forHbA1c at 34 weeks.
The bottom line
This study concluded that higher HbA1c levels during the second and third trimesters were associated with an increased risk of adverse outcomes. The authors suggested that it was worthwhile for women with T1D to undergo regular HbA1c measurements.
The fine print
Patients must balance their blood sugar control with the prevention of hypoglycemia (dangerously low blood sugar).
What’s next?
Consult with your doctor about the appropriate HbA1c target and how to maintain it.
Published By :
Diabetes Care
Date :
Nov 03, 2014
