Postpregnancy Glycemic Control and Weight Changes in Type 1 Diabetic Women

  1. Maciej T. Malecki, MD, PHD1,4
  1. 1University Hospital, Krakow, Poland
  2. 2Section on Genetics and Epidemiology, Joslin Diabetes Center, Boston, Massachusetts
  3. 3Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  4. 4Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
  1. Corresponding author: Maciej T. Malecki, malecki_malecki{at}yahoo.cm.

Abstract

OBJECTIVE Pregnancy in type 1 diabetes requires excellent glycemic control. Most pregnant type 1 diabetic women achieve normoglycemia; however, there is scarce data on their postdelivery characteristics. We aimed to examine postpregnancy glycemic control and weight changes in type 1 diabetes.

RESEARCH DESIGN AND METHODS We identified and followed (median 20 months) 254 women with singleton pregnancies receiving postdelivery medical care at a single institution.

RESULTS Study subjects were 28.3 ± 4.7 years of age (mean ± SD), with a diabetes duration of 12.0 ± 7.7 years. Mean A1C before conception was 6.9 ± 1.4%, and preconception weight and BMI were 64.4 ± 10.0 kg and 23.9 ± 3.3 kg/m2, respectively. Mean A1C decreased during pregnancy, reaching 5.7 ± 0.8% in the third trimester. We observed a mean weight gain of 14.4 ± 6.5 kg during pregnancy. Within 6 months after delivery, A1C increased by 0.8% (P < 0.0001) compared with the last trimester, and body weight and BMI were 4.4 kg and 2.5 kg/m2 higher (P < 0.0001) compared with the preconception baseline. A1C further deteriorated by 0.8% until the end of follow-up. For women in the “pregnancy planning” program (n = 117), A1C >12 months after delivery was worse compared with before conception (7.1 vs. 6.5%, P = 0.0018), whereas in women with unplanned pregnancies, it was similar to the pregestational levels (7.3 vs.7.4%, P = 0.59). Weight and BMI in the entire study group did not return to prepregnancy levels and were 2.5 kg (P = 0.0079) and 0.9 kg/m2 higher (P = 0.0058).

CONCLUSIONS In this clinical observation, type 1 diabetic women showed postpregnancy deterioration in glycemic control and were unable to return to prepregnancy weight. Type 1 diabetic women seem to require special attention after delivery to meet therapeutic targets.

  • Received July 7, 2012.
  • Accepted October 18, 2012.

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This Article

  1. Diabetes Care
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