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Comparing type 1 and type 2 diabetes in pregnancy- similar conditions or is a separate approach required?

BACKGROUND: Pregnancy in women with type 1 (T1DM) or type 2 diabetes (T2DM) is associated with increased risk. These conditions are managed similarly during pregnancy, and compared directly in analyses, however they affect women of different age, body mass index and ethnicity. METHODS: We assess if...

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Autores principales: Owens, Lisa A, Sedar, Jon, Carmody, Louise, Dunne, Fidelma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390076/
https://www.ncbi.nlm.nih.gov/pubmed/25885892
http://dx.doi.org/10.1186/s12884-015-0499-y
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author Owens, Lisa A
Sedar, Jon
Carmody, Louise
Dunne, Fidelma
author_facet Owens, Lisa A
Sedar, Jon
Carmody, Louise
Dunne, Fidelma
author_sort Owens, Lisa A
collection PubMed
description BACKGROUND: Pregnancy in women with type 1 (T1DM) or type 2 diabetes (T2DM) is associated with increased risk. These conditions are managed similarly during pregnancy, and compared directly in analyses, however they affect women of different age, body mass index and ethnicity. METHODS: We assess if differences exist in pregnancy outcomes between T1DM and T2DM by comparing them directly and with matched controls. We also analyze the effect of glycemic control on pregnancy outcomes and analyze predictive variables for poor outcome. RESULTS: We include 323 women with diabetes and 660 glucose-tolerant controls. T2DM women had higher BMI, age and parity with a shorter duration of diabetes and better glycemic control. Preeclampsia occurred more in women with T1DM only. Rates of elective cesarean section were similar between groups but greater than in controls, emergency cesarean section was increased in women with type 1 diabetes. Maternal morbidity in T1DM was double that of matched controls but T2DM was similar to controls. Babies of mothers with diabetes were more likely to be delivered prematurely. Neonatal hypoglycemia occurred more in T1DM than T2DM and contributed to a higher rate of admission to neonatal intensive care for both groups. Adverse neonatal outcomes including stillbirths and congenital abnormalities were seen in both groups but were more common in T1DM pregnancies. HbA1C values at which these poor outcomes occurred differed between T1 and T2DM. CONCLUSIONS: Pregnancy outcomes in T1DM and T2DM are different and occur at different levels of glycemia. This should be considered when planning and managing pregnancy and when counseling women.
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spelling pubmed-43900762015-04-09 Comparing type 1 and type 2 diabetes in pregnancy- similar conditions or is a separate approach required? Owens, Lisa A Sedar, Jon Carmody, Louise Dunne, Fidelma BMC Pregnancy Childbirth Research Article BACKGROUND: Pregnancy in women with type 1 (T1DM) or type 2 diabetes (T2DM) is associated with increased risk. These conditions are managed similarly during pregnancy, and compared directly in analyses, however they affect women of different age, body mass index and ethnicity. METHODS: We assess if differences exist in pregnancy outcomes between T1DM and T2DM by comparing them directly and with matched controls. We also analyze the effect of glycemic control on pregnancy outcomes and analyze predictive variables for poor outcome. RESULTS: We include 323 women with diabetes and 660 glucose-tolerant controls. T2DM women had higher BMI, age and parity with a shorter duration of diabetes and better glycemic control. Preeclampsia occurred more in women with T1DM only. Rates of elective cesarean section were similar between groups but greater than in controls, emergency cesarean section was increased in women with type 1 diabetes. Maternal morbidity in T1DM was double that of matched controls but T2DM was similar to controls. Babies of mothers with diabetes were more likely to be delivered prematurely. Neonatal hypoglycemia occurred more in T1DM than T2DM and contributed to a higher rate of admission to neonatal intensive care for both groups. Adverse neonatal outcomes including stillbirths and congenital abnormalities were seen in both groups but were more common in T1DM pregnancies. HbA1C values at which these poor outcomes occurred differed between T1 and T2DM. CONCLUSIONS: Pregnancy outcomes in T1DM and T2DM are different and occur at different levels of glycemia. This should be considered when planning and managing pregnancy and when counseling women. BioMed Central 2015-03-27 /pmc/articles/PMC4390076/ /pubmed/25885892 http://dx.doi.org/10.1186/s12884-015-0499-y Text en © Owens et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Owens, Lisa A
Sedar, Jon
Carmody, Louise
Dunne, Fidelma
Comparing type 1 and type 2 diabetes in pregnancy- similar conditions or is a separate approach required?
title Comparing type 1 and type 2 diabetes in pregnancy- similar conditions or is a separate approach required?
title_full Comparing type 1 and type 2 diabetes in pregnancy- similar conditions or is a separate approach required?
title_fullStr Comparing type 1 and type 2 diabetes in pregnancy- similar conditions or is a separate approach required?
title_full_unstemmed Comparing type 1 and type 2 diabetes in pregnancy- similar conditions or is a separate approach required?
title_short Comparing type 1 and type 2 diabetes in pregnancy- similar conditions or is a separate approach required?
title_sort comparing type 1 and type 2 diabetes in pregnancy- similar conditions or is a separate approach required?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390076/
https://www.ncbi.nlm.nih.gov/pubmed/25885892
http://dx.doi.org/10.1186/s12884-015-0499-y
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