Research Study on Pregnancy Outcomes in Patients with Prepubertal Onset of Type I Diabetes Mellitus

Agenda: to study attributes of pregnancy in patients with prepubertal onset of type I diabetes mellitus (DM1). Products and Methods: The subject of the study was 27 primiparous females, the average age of the patients at the time of pregnancy was 24.3 u00 b1 4.9 years, the average age of debut of the illness was 9.9 u00 b1 3.9 years, the average period of diabetes was 11.2 u00 b1 3.4 years. All patients received recombinant analogues of human insulin (Detemir and Aspart) in multiple injections regimen (basal-bolus). Assessment of carb metabolism consisted of: self-monitoring of glycemia (SMPG), fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) before pregnancy, during pregnancy and after childbirth.Studyresults: Analysis of microvascular issues showed that 48% (13) of clients had diabetic nonproliferative retinopathy, 41% (11) had diabetic nephropathy of varying seriousness, 4 clients (15%) had IV-V stage of persistent kidney disease.All patients reported not extreme hypoglycemia during the first trimester of pregnancy, while 3 clients (111%) had extreme hypoglycemia. The typical everyday requirement for insulin changed with the course of pregnancy. In the first trimester the typical day-to-day dosage was 46.7 u00 b1 11.0 U, in the 2nd trimester – 51.6 u00 b1 15.6 U, after birth – 48.6 u00 b1 9.7 U. The mean HbA1c before pregnancy was 8.1 u00 b1 1.1%, the mean HbA1c throughout pregnancy was 6.81 u00 b1 1.5% and after childbirth at 3 months, 8.8 u00 b1 1.6%. The following pregnancy results were observed: the pregnancy was disrupted in 3 patients due to medical sign (early toxicosis, consistent throwing up of pregnant women, development of diabetic nephropathy). In 17 clients (63%), the delivery was by caesarean section, with 11 cases at 34-36 weeks of gestation and 6 cases at 38-39 weeks. Only 7 (26%) of the clients had a natural birth in a duration of 38-39 weeks. No cases of fetal death have actually been reported.Conclusions: Women with pregestational DM1 have high level microvascular issues (50%). Throughout duration of pregravid preparation, glycaemic control is not at target goal (HBA1c – 8.1 u00 b1 1.1%), due to the fact that ladies with diabetes do not notify the doctor about pregnancy planning.Insulin Detemir and Aspart in indicator basis-bolus regimen throughout pregnancy works and does not have a negative result on pregnancy outcomes.

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