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Sugar control cuts preeclampsia risk in diabetics
NEW YORK (Reuters Health) - Pregnant women with type 1 diabetes who maintain good control of their blood sugar levels during the second trimester are at decreased risk for developing preeclampsia, a potentially serious pregnancy complication involving high blood pressure and fluid retention, according to a report in the journal BJOG.
"Achieving excellent (sugar) control in the second trimester of pregnancy (rather than in first or third) may reduce the risk of preeclampsia in women with...diabetes," Dr. Rosemary C. Temple told Reuters Health. Diabetes type 1, also called juvenile diabetes, tends to begin during childhood and is potentially more serious than type 2 diabetes, which typically develops in adulthood in people who are overweight.
Temple and colleagues from Norfolk and Norwich University Hospital NHS Trust, UK, examined the relationship between sugar control at different stages of pregnancy and the risk of preeclampsia during 290 pregnancies in 178 women with type 1 diabetes.
Women who developed preeclampsia had significantly worse sugar control at 24 weeks than those who did not develop preeclampsia and at 12 weeks, the investigators report.
In contrast, the results indicate, sugar control in the first and third trimesters did not differ significantly between women who did and did not develop preeclampsia.
"Greater attention must be given to supporting women to optimize (sugar) control during the second trimester if further progress is to be made," the team concludes.
"Ideal management of blood (sugar) levels during pregnancy in women with type 1 diabetes should include women testing blood (sugar) at least seven times daily (before and 1-2 hours after meals)" and then administering insulin to achieve recommended levels, Temple said.
"We would advise all women to use a glucometer with a memory facility so the physician can download data at each clinic visit to verify all blood (sugar) levels," she added.
"We would hope to do future studies using continuous (sugar) monitoring systems and/or subcutaneous insulin infusions to see if using these new technologies would help to improve (sugar) control and reduce risk of preeclampsia in women with type 1 diabetes," Temple commented.
SOURCE: BJOG, December 2006.
Reuters Health