U. ROCHESTER (US) — Pregnant women with type 2 diabetes have a better chance for a good outcome than those with type 1, particularly if they receive proper care before and during their pregnancy.
A new study published in the Journal of Reproductive Medicine shows the importance of separating type 1 diabetes from type 2 when considering treatment. Historically, research on diabetes during pregnancy did not differentiate between the two types.
“With the rapid rise of type 2 diabetes in reproductive-age women, it is important to look at it separate from type 1 so we know how best to support and care for type 2 diabetics to promote the best possible outcomes in pregnancy,” says Eva K. Pressman, professor of obstetrics and gynecology and head of the division of maternal fetal medicine at the University of Rochester Medical Center.
Type 1 diabetics in the study had a higher incidence of complications and of poor outcomes than the type 2 and non-diabetic women. For example, 20 percent of the type 1 diabetics had preeclampsia, a condition marked by elevated blood pressure and protein in the urine, compared with 14 percent of type 2 and 1 percent of non-diabetics. Type 1 mothers who had never had a cesarean delivery had a 50 percent cesarean-section rate, compared with 27 percent for type 2 and 13 percent for non-diabetics.
Babies of type 2 diabetics in the study had a higher incidence of being large for their gestational age, at 38 percent, versus 23 percent for type 1 mothers and just 3 percent for non-diabetic moms. Eighty-five percent of babies born to type 1 moms required admission to the neonatal intensive care unit, compared with 71 percent born to type 2 moms and 11 percent of non-diabetic moms.
Pressman, who co-authored the study with colleagues Loralei L. Thornburg, and Kristin M. Knight, reviewed medical records from a six-year period ending in 2006, comparing pregnancies and outcomes of 64 women with type 1 and 64 women with type 2, to those of 256 non-diabetic women.
Not surprisingly, on the whole, non-diabetic mothers and their babies fared better than diabetics in terms of outcomes from childbirth, Pressman says.
“Further studies that distinguish type 1 and type 2 diabetes, using comparisons with non-diabetic control groups, will become increasingly important as we seek to improve outcomes for women and their babies in light of the rising prevalence of type 2 diabetes.”
Source: University of Rochester