Women with more common type may have better outcomes
Pregnant women with Type 2 diabetes have a better chance at good outcomes than those with Type 1, particularly if they receive proper care before and during their pregnancy, according to a University of Rochester Medical Center (URMC) study published in the Journal of Reproductive Medicine (Nov. 2012).
"With the rapid rise of Type 2 diabetes in reproductive-age women, it is important to look at it separate from Type 1 so we know how best to support and care for Type 2 diabetics to promote the best possible outcomes in pregnancy," said Eva K. Pressman, M.D., professor of obstetrics and gynecology and head of the division of maternal fetal medicine at URMC. Historically, research on diabetes in pregnancy did not differentiate between the two types, according to Pressman.
In Pregnancy, Type 2 Diabetes May Pose Less Risk than Type 1
The URMC study revealed that Type 1 diabetics had a higher incidence of complications and of poor outcomes than the Type 2 and non-diabetic women. For example, 20 percent of the Type 1 diabetics had preeclampsia, a condition marked by elevated blood pressure and protein in the urine, compared with 14 percent of Type 2 and 1 percent of non-diabetics. Type 1 mothers who had never had a cesarean delivery had a 50 percent cesarean-section rate, compared with 27 percent for Type 2 and 13 percent for non-diabetics.
Babies of Type 2 diabetics in the study had a higher incidence of being large for their gestational age, at 38 percent, versus 23 percent for Type 1 moms and just 3 percent for non-diabetic moms. Eighty-five percent of babies born to Type 1 moms required admission to the neonatal intensive care unit, compared with 71 percent born to Type 2 moms and 11 percent of non-diabetic moms.
Pressman, who co-authored the study with URMC colleagues Loralei L. Thornburg, M.D., and Kristin M. Knight, M.D., reviewed medical records from a six-year period ending in 2006, comparing pregnancies and outcomes of 64 women with Type 1 and 64 women with Type 2, to those of 256 non-diabetic women. Not surprisingly, on the whole, non-diabetic mothers and their babies fared better than diabetics in terms of outcomes from childbirth.
"Further studies that distinguish Type 1 and Type 2 diabetes, using comparisons with non-diabetic control groups, will become increasingly important as we seek to improve outcomes for women and their babies in light of the rising prevalence of Type 2 diabetes," Pressman said.