Endocrine Abstracts

Background: Type 1 diabetes (T1DM) affects young women of childbearing age. Type 2 diabetes (T2DM) is also increasingly affecting this age group due to obesity increase. The aim of this study was to determine the characteristics of diabetes affecting a group of women at procreative age.

Methods: We conducted a descriptive cross-sectional study among pregnant women followed for pre-gestational diabetes at the Department of Nutritional Diseases « D » of the National Institute of Nutrition of Tunis, between January and December 2023.

Results: We included 100 diabetic patients with a mean age of 34.12±4.9 years [ext:23-44 years]. The level of education was primary, secondary and high in 34%, 43% and 23%, respectively. Most patients (82%) had T2DM. The mean duration of diabetes was 13.61±7.36 years for T1DM and 3.61±2.92 years for T2DM. Before pregnancy, about the half of patients (51%) were treated with metformin and 21.6% with insulin (among them, 21.6% were treated with insulin analogs). At the first diabetes consultation in pregnancy, the mean glycated hemoglobin (A1c) was 7.8±1.6% with extremes from 5.9% to 12%. More than the half of the patients (57%) had an A1c level higher than 7%. Hypoglycemic episodes were reported by 22% of patients. Diabetic retinopathy affected 39% of T1DM and 6% of T2DM. Diabetic nephropathy affected 12% of T1DM. However, none of the T2DM had this complication. Hypertension, dyslipidemia, anemia and hypothyroidism affected 3%,6%,3%,7% of patients, respectively. The prevalence of planned pregnancies was 28% in the T1DM group and 11% in the T2DM group. Pregnancy planning was associated with: the university level of education (P=0.026), the presence of microangiopathic complications before pregnancy (P=0.036) and pre-gestational treatment with insulin analogs (P=0.004).

Conclusion: The preconception consultation is essential in the management of the futur pregnant diabetic women to anticipate and prevent maternal and fetal complications. Then, educating women about the benefits of this consultation is essential.