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Improving IV Insulin Administration in a Community Hospital

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Severe hypoglycaemia during pregnancy in women with Type 1 diabetes is common and planning pregnancy does not

H Robertson¹, D W M Pearson, A E Gold

¹Department of Diabetes, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK.

Diabetic Medicine : a Journal of the British Diabetic Association

|August 28, 2009

Summary

Severe hypoglycemia (SH) is common in pregnancy for women with Type 1 diabetes, especially in the first trimester. Planning pregnancy does not reduce SH risk, highlighting the need for education on SH management.

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Area of Science:

Endocrinology
Obstetrics
Diabetes Management

Background:

Severe hypoglycemia (SH) poses significant risks during pregnancy for women with Type 1 diabetes.
Understanding risk factors is crucial for optimizing maternal and fetal outcomes.

Purpose of the Study:

To identify risk factors for severe hypoglycaemia (SH) in pregnant women with Type 1 diabetes.
To explore associations between SH, pregnancy planning, and glycaemic control.

Main Methods:

Prospective data collection from 160 pregnancies in women with Type 1 diabetes.
Analysis of clinical data, including pregnancy details, glycaemic control (HbA1c), SH frequency, and pregnancy planning.
Statistical analysis to identify risk factors for SH across trimesters.

Main Results:

SH occurred in 29.4% of pregnancies, decreasing from 21.9% in trimester 1 to 10.9% in trimester 3.
Longer diabetes duration correlated with increased SH frequency (r = 0.191, P = 0.012).
Planned pregnancies showed better glycaemic control but higher SH risk in trimester 1 (P = 0.047). Pre-pregnancy retinopathy and smoking increased SH risk in trimester 3 (P = 0.029, P = 0.033).

Conclusions:

Severe hypoglycemia is prevalent in pregnancy, particularly in the first trimester.
Pregnancy planning does not mitigate SH risk; education on SH risks and management is essential.
Improved pre-pregnancy glycaemic control does not appear to elevate SH risk.