Type 1 Diabetes in Pregnancy

Endocrinol Metab Clin North Am. 2019 Sep;48(3):495-509. doi: 10.1016/j.ecl.2019.05.008.

Abstract

Congenital malformations and perinatal mortality rates remain severalfold higher in pregnant women with type 1 diabetes than in the background population, and still only a minority of women plan their pregnancy. Optimizing glycemic control is the accepted goal, but remains challenging, and must be constantly balanced against the risks of hypoglycemia. Recent advances including Continuous Glucose Monitoring Systems, Continuous Subcutaneous Insulin Infusion, Closed Loop Devices and very Fast Acting Insulin Aspart analogs offer new possibilities to increase glucose time in target in selected, motivated patients, however their relative roles and indication for use require further elucidation. The importance of education cannot be overstated.

Keywords: Glycemic control; Maternal/fetal outcomes; Pregnancy; Type 1 diabetes.

Publication types

  • Review

MeSH terms

  • Blood Glucose / analysis
  • Blood Glucose Self-Monitoring
  • Diabetes Mellitus, Type 1* / blood
  • Diabetes Mellitus, Type 1* / diagnosis
  • Diabetes Mellitus, Type 1* / epidemiology
  • Diabetes Mellitus, Type 1* / therapy
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Insulin / administration & dosage
  • Insulin Infusion Systems
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnancy in Diabetics* / blood
  • Pregnancy in Diabetics* / diagnosis
  • Pregnancy in Diabetics* / epidemiology
  • Pregnancy in Diabetics* / therapy
  • Prognosis

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin