Endocrine Abstracts

The work was initiated to comparatively study pregnancy outcomes in patients with type I diabetes mellitus (DMI) with self-control skills and without them.

We examined 50 patients with DMI aged from 20 to 29 (mean age 24±3.2 years) ranging from those with newly diagnosed disease to those with DMI duration under 12 years. Glycemia and HBA1c levels were measured to assess carbohydrate metabolism.

40 patients with planned pregnancy having self-control skills were included into the first group, the second control one comprising ten patients referred for the specialized medical aid at various gestational ages. 3 months prior to pregnancy mean HbA1c level was 6.6±0.2 and 9.3±0.3% in the first and second groups respectively (normal range from 4.5 to 6.7%). All patients in the first group received intensive insulin therapy and completed self-control training under special program. In the second group not all women demonstrated patient compliance, most having unplanned pregnancy, but not completed special training. Mean fasting, postprandial, and average daily glycemia in the first group patients all through pregnancy was 6.0, 7.5, and 7.2 mmol/l respectively. In our study severe hypoglycemia absent, mild hypoglycemia episodes were compensated by the patients themselves (n=18, 36.6%). Mean fasting and post-prandial glycemia was 8.3±0.3 and 12.0 mmol/l respectively; HbA1c gradually reducing to 7.8±0.3% in the second group patients. Favorable outcomes of pregnancy were predetermined by sufficient compensation of carbohydrate metabolism. In the first group all 40 pregnancies completed with birth of viable children; thus, there were 24 natural deliveries and 16 cesarean sections for obstetrical indications. Fetopathy was registered in 13 (32.5%) newborns. In the second group eight pregnancies completed with birth of viable children, in one woman the pregnancy was terminated due to hydrocephaly at 19th week, in another one because of prenatal death. Eight newborns were born with fetopathy, one having macrosomia, and hypoglycemia. Planning of pregnancy in women completing self-control training with intensive insulin therapy regimen allows attaining adequate compensation of carbohydrate metabolism in patients with DMI and eventually results in favorable outcomes of pregnancy and deliveries.