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Type 1 diabetes during pregnancy linked to increased risk of hypoglycemic episodes
![Type 1 diabetes during pregnancy linked to increased risk of hypoglycemic episodes Type 1 diabetes during pregnancy linked to increased risk of hypoglycemic episodes](https://medicaldialogues.in/h-upload/2021/04/19/750x450_151390-nocturnal-hypoglycemia.webp)
USA: Pregnant women with type 1 diabetes have a sustained daytime risk of hypoglycemia, which tends to happen more frequently overnight during pregnancy, states a study published in the journal of Diabetes Technology & Therapeutics.
Up to 10% of all pregnancies in the US are complicated by diabetes. 0.2% to 0.5% of these are people with type 1 diabetes (T1DM). With traditional insulin replacement therapy, hypoglycemia, especially at night, is a frequent occurrence. Type 1 diabetes carries a high risk for pregnancies, and there is little information available in the United States about hypoglycemia based on continuous glucose monitoring (CGM) during pregnancy in patients using sensor-assisted insulin pump therapy.
The authors of the study aimed to record hypoglycemia during pregnancy in women on sensor-assisted insulin pump therapy and using continuous glucose monitoring (CGM).
For this purpose, 25 pregnant women's data were examined for CGM hypoglycemia using international consensus recommendations for percentage time <63 and 54 mg/dL, hypoglycemic events, persistent hypoglycemia events for 24-h, daytime, and nocturnal periods, and severe hypoglycemia (SH) episodes. Before 17 weeks of pregnancy, type 1 diabetic pregnant women were enrolled in the LOIS-P Study (Longitudinal Observation of Insulin use and glucose Sensor metrics in Pregnant women with type 1 diabetes using continuous glucose monitors and insulin pumps). The authors used a study Dexcom G6 CGM in addition to their own insulin pump.
Key findings of the study:
- The biweekly median percentage of time 63 mg/dL over a 24-hour period varied greatly throughout pregnancy, from 0.8% at biweek 4-5 to 3.7% at biweek 14-15.
- Overnight, there was a greater median percentage of time between 63 and 54 mg/dL than during the day.
- Throughout the entire pregnancy, there were 1-4 hypoglycemic incidents every two weeks, however, they considerably decreased after the 20th week and mostly happened during the day.
- From 12 to 3 am during the overnight period, there were increased hypoglycemic and event occurrences.
- Four subjects (16%) experienced seven protracted hypoglycemic bouts, mostly over the course of one night, without any concomitant severe hypoglycemia(SH). A single episode of SH was experienced by three subjects.
The authors concluded that in pregnancies complicated by type 1 diabetes, there was a substantially greater risk of hypoglycemia throughout pregnancy during the nocturnal period with a persistent daily risk of hypoglycemic episodes.
REFERENCE
Kaur RJ, Smith BH, Ozaslan B, Pinsker JE, Trinidad MC, O'Malley G, Desjardins D, Castorino KN, Levister C, Reid C, McCrady-Spitzer S, Ogyaadu SJ, Church MM, Piper M, Kremers WK, Rosenn B, Doyle FJ 3rd, Dassau E, Levy CJ, Kudva YC. Hypoglycemia in Prospective Multicenter Study of Pregnancies with Pre-Existing Type 1 Diabetes on Sensor-Augmented Pump Therapy: The LOIS-P Study. Diabetes Technol Ther. 2022 Aug;24(8):544-555. doi: 10.1089/dia.2021.0479. PMID: 35349353; PMCID: PMC9353990.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751