Endocrine Abstracts

Objective: The aim of this study was to evaluate maternal and neonatal outcomes in women with type 1 diabetes mellitus (DM1), and analysing differences associated to insulin glargine exposure during pregnancy.

Patients and methods: Retrospective descriptive study of pregnancies in women with DM1 (2004–2012). Variables analysed: baseline characteristics (age, time of diabetes evolution, microvascular complications, and weight), maternal outcomes (weight gain, HbA1c, hypoglycaemia, preeclampsia, abortions, and vaginal delivery and caesarean section) and neonatal outcomes (gestational age at delivery, birth weight, and congenital malformations). The pregnancies were divided in groups attending to their exposition to glargine insulin and were analysed to evaluate possible differences between them (group 1: exposed and group 2: unexposed).

Statistical analysis: Comparing proportions with the χ² and comparing means with Student’s t-test.

Results: 132 pregnancies in women with DM1. Group 1: 57 (43.2%) and group 2: 75 (56.8%). Baseline characteristics were similar in both groups. HbA1c was different before pregnancy (group 1 vs group 2: 7.95% vs 7.02%; P=0.001), but similar during pregnancy (group 1 vs group 2: first trimester 6.83% vs 6.47%; second trimester 6.45% vs 6.33%; and third trimester 6.67% vs 6.42%; P>0.05). Maternal weight gain was similar in both groups (group 1 vs group 2: 10.28 kg vs 11.02 kg, P=0.4). Maternal and neonatal outcomes (group 1 vs group 2): abortions 1 (2%) vs 9 (12%), P=0.05; caesarean section 18 (31.5%) vs 39 (52%), P=0.005; gestational age at delivery 38.02 weeks vs 38.12 weeks, P=0.93; macrosomia 13 (23%) vs 21 (28%), P=0.29; congenital malformations 3 (23%) vs 6 (28%), P=0.49; and neonatal hypoglyceamia 1 (2%) vs 5 (7%), P=0.13.

Conclusions: The number of caesarean sections was higher in women not exposed to insulin glargine. Insulin glargine use before and during pregnancy is not associated with worse maternal and neonatal outcome, or congenital malformation.