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- Title
Impaired awareness of hypoglycaemia: A new risk factor for adverse pregnancy outcomes in type 1 diabetes.
- Authors
Perea, Verónica; Bertran, Berta; Bellart, Jordi; Orois, Aida; Giménez, Marga; Conget, Ignacio; Vinagre, Irene
- Abstract
<bold>Aim: </bold>The aim of this study is to evaluate the impact of impaired awareness of hypoglycaemia (IAH) on metabolic control and pregnancy outcomes in women with type 1 diabetes.<bold>Material and Methods: </bold>This was a single-centre prospective cohort study of singleton pregnant women with type 1 diabetes. IAH was assessed at the first antenatal visit using Clarke's test (score ≥ 3). Data on metabolic control, hypoglycaemic events, and the lipid profile were collected from prior to pregnancy and in each trimester of gestation. Pregnancy outcomes were also recorded.<bold>Results: </bold>A total of 77 patients with type 1 diabetes were included; 24 (31.2%) were classified as having IAH. Compared with the normal awareness of hypoglycaemia (NAH) group, the IAH group did not show differences in HbA1c , weight gain, insulin doses, or severe and nonsevere hypoglycaemia events throughout pregnancy. IAH was associated with higher triglyceride concentrations in the second trimester (IAH: 154.8 ± 61.1 mg/dL, NAH: 128.6 ± 31.2 mg/dL, P = .034) and an increased risk of neonatal respiratory distress (odds ratio [OR] 11.24; 95% CI, 1.01-124.9, P = .041) in adjusted models. Increased risk of pre-eclampsia was related to higher second trimester triglyceride concentrations (OR 1.028; 95% CI, 1.004-1.053, P = .023) adjusted for confounders.<bold>Conclusions: </bold>The IAH was associated with increased risk of neonatal respiratory distress and pre-eclampsia, despite showing no differences in metabolic control. Hypoglycaemia awareness in the first antenatal visit should be assessed to identify the subgroup of pregnant women with increased risk of complications.
- Subjects
HIGH-risk pregnancy; TYPE 1 diabetes; PREGNANT women; METABOLIC regulation; AWARENESS; DIABETES complications; BLOOD sugar analysis; HYPOGLYCEMIC agents; COGNITION; PREGNANCY outcomes; PREGNANCY complications; HEALTH attitudes; HYPOGLYCEMIA; LONGITUDINAL method
- Publication
Diabetes/Metabolism Research & Reviews, 2019, Vol 35, Issue 7, pN.PAG
- ISSN
1520-7552
- Publication type
journal article
- DOI
10.1002/dmrr.3176