Assessing Insulin Requirements in Pregnant Women with Type 1 Diabetes
Women with type 1 diabetes mellitus (T1DM) whose insulin requirements decrease during their pregnancy may not suffer from any adverse neonatal outcomes, according to a study. Since pregnancy in women with T1DM is usually linked with an increase in insulin requirements, researchers in Australia were interested in determining the frequency of decreasing insulin requirements in pregnant women, as well as the effects on newborns.
The study, “Insulin requirements in late pregnancy in women with type 1 diabetes mellitus: A retrospective review,” was conducted by researchers at the Royal Brisbane and Women’s Hospital in Queensland, Australia. It was published online ahead of print in October 2012 in the journal Diabetes Research and Clinical Practice.
The researchers collected data on 54 women who were seen at their hospital between 2006 and 2010. All of the women had a diagnosis of T1DM prior to their pregnancy. The study authors collected information on demographic factors, changes in insulin dose during pregnancy, and the women’s pregnancy outcomes. Women who had a 15% difference in insulin dosage between 30 weeks gestation and delivery were considered to have significant increases or decreases in insulin requirements.
The results of the study showed that 9.3% of the women (5 out of 54) had a decrease in insulin requirements of 15% or more. Approximately 42% of the participants (23 out of 54) had a rise of more than 15%. The researchers found that neonatal intensive care admissions were fewer in women who had a decrease in insulin requirements, but these women were also more likely to have infants with low APGAR newborns scores (at 5 minutes). However, these results were not seen when further statistical models were applied to the data.
The study authors conclude that approximately 10 % of the women in their study had a significant decline in their insulin requirements, but that this fall did not necessarily result in adverse neonatal outcomes.