Post-pregnancy deterioration in glycemic control in T1DM

(HealthDay)—Women with type 1 diabetes experience post-pregnancy deterioration in glycemic control and sustained weight gain, according to research published online Dec. 18 in Diabetes Care.

Katarzyna Cyganek, M.D., Ph.D., of the University Hospital in Krakow, Poland, and colleagues examined post-pregnancy glycemic control and weight changes in 254 women (mean age, 28.3 years) with type 1 diabetes (duration, 12.0 ± 7.7 years) who had singleton pregnancies. The women were followed post-delivery for a median of 20 months.

The researchers found that the mean A1C decreased from 6.9 percent preconception to 5.7 percent during the third trimester. The mean weight gain during pregnancy was 14.4 kg. Within six months of delivery, A1C increased significantly, by 0.8 percent versus the last trimester, and it further deteriorated by 0.8 percent up to the end of follow-up. Compared with preconception baseline, body weight was 4.4 kg higher and body mass index was 2.5 kg/m² higher within six months after delivery, and were 2.5 kg and 0.9 kg/m² higher, respectively, at the end of follow-up. Women with planned pregnancies (117 women) experienced worse A1C at more than 12 months after delivery compared with before conception, while for women with unplanned pregnancies the level was similar to that of pre-gestation.

"In conclusion, type 1 diabetic women showed post-pregnancy deterioration in glycemic control. They were also unable to return to their pre-pregnancy weight," the authors write. "Type 1 diabetic women seem to require special medical attention after delivery to maintain their diabetes control within therapeutic targets."