Document Detail

The pregnancies of women with Type 2 diabetes: poor outcomes but opportunities for improvement.
MedLine Citation:
PMID:  16401329     Owner:  NLM     Status:  MEDLINE    
AIM: To compare the outcomes of Type 1 and Type 2 diabetic pregnancies and identify risk factors for poor outcome of Type 2 pregnancies METHODS: The data from all (389 Type 1 and 146 Type 2) pre-gestational diabetic pregnancies from 10 UK hospitals were collected prospectively. RESULTS: The Type 2 mothers were less likely to have documented pre-pregnancy counselling (28.7 vs. 40.5%; P<0.05) or be taking folic acid at conception (21.9 vs. 36.4%; P<0.001) than Type 1 mothers. The percentage of pregnancies having a serious adverse outcome was higher in Type 2 patients (16.4 vs. 6.4%; P=0.002). Congenital abnormalities (12.3% in Type 2 vs. 4.4% in Type 1; P=0.002) accounted for most of this difference. The HbA1c of the Type 2 patients was similar to that of the Type 1 with mean first trimester HbA1c of 7.22 and 7.35%, respectively (P=0.5). Treatment with oral hypoglycaemic agents [odds ratio (OR), 1.8; 95% confidence interval (CI), 1.0-3.3; P=0.04], body mass index (OR, 1.09; 95% CI, 1.01-1.18; P=0.02) and folic acid supplementation (OR, 0.3; 95% CI, 0.09-1.0; P=0.04) were all independently associated with congenital malformation. CONCLUSION: Type 2 diabetic pregnancies are characterized by poor pre-pregnancy planning, inadequate folic acid supplementation and treatment with oral hypoglycaemic agents, all of which may contribute to the serious adverse outcomes affecting one in six Type 2 diabetic pregnancies. These remediable aspects of the pre-pregnancy care of women with Type 2 diabetes provide opportunities for improving the outcome towards that of women with Type 1 diabetes.
J M Roland; H R Murphy; V Ball; J Northcote-Wright; R C Temple
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  22     ISSN:  0742-3071     ISO Abbreviation:  Diabet. Med.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-01-10     Completed Date:  2006-05-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1774-7     Citation Subset:  IM    
Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, and Norwich University, UK.
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MeSH Terms
Diabetes Mellitus, Type 1 / complications,  therapy*
Diabetes Mellitus, Type 2 / complications,  therapy*
Fetal Death
Fetus / abnormalities
Hemoglobin A, Glycosylated
Pregnancy Outcome*
Pregnancy in Diabetics / therapy*
Prenatal Care / standards*
Prospective Studies
Risk Factors
Reg. No./Substance:
0/Hemoglobin A, Glycosylated

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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