Endocrine Abstracts

Background and aims: To study the need for insulin during pregnancy, depending on the duration of the disease.

Methods: We studied 108 pregnant women with DM 1 receiving insulin with insulin pumps. Patients were divided into three groups: in the 1st group diabetes duration was less than 5 years, in the 2nd – 5 to 15 years, 3rd – more than 15 years. We evaluated the daily need for insulin on 12, 22–25, 30–32 weeks of gestation.

Results: In the 1st group the daily insulin requirement (IU/kg) in the 1st trimester was 0.51, in the 2nd 0.54, in the 3rd 0.79. Significant increase of insulin requirements was identified from the second to the third trimester (P=0.34 between 1 and 2 trimester, P=0.005 between the 2 and 3 trimester, P<0.01 between 1 and 3 trimester). By the third trimester the increase of the daily dose of insulin was on 56% (36; 87). In the 2nd group the insulin requirement was 0.6; 0.73; to 0.87 IU/kg, respectively, dose increased from trimester to trimester (P<0.01). By the third trimester, daily dose of insulin increased on 42% (28; 63). Insulin requirements in the 3rd group increased from the first (0.59 IU/kg) to second (0.65 IU/kg) trimester, but in third trimester dose stabilized on 0.74 IU /kg (P<0.01 between 1 and 2 trimester, P=0.17 between the 2 and 3 trimester, P<0.01 between 1 and 3 trimester). However, the daily dose of insulin in this group increased only on 22% (11.5; 32.5).

Conclusions: In pregnant women with DM 1 with disease duration more than 15 years we may not see a significant rise in insulin requirements on the third trimester. This group needs monitoring.