Excess Weight Gain During Pregnancy on the Rise for Women With Type 1 Diabetes

The rate of weight gain during pregnancy, use of insulin pumps, and CGMS have increased in women with type 1 diabetes, according to new research.

Excess weight gain during pregnancy, the use of insulin pumps, and CGMS have increased significantly in women with type 1 diabetes (T1D), according to new research published in Journal of Perinatology.

Research from the Joslin Diabetes Center found that the prevalence of nephropathy in pregnant women with T1D fell dramatically to 0. According to the press release, the percentage of women with T1D prior to pregnancy increased almost 40% in the past 2 decades. Research also shows a trend towards increased obesity in this population. However, according to the press release, the percentage of very large babies born to this population remains the same.

The medical records of 700 pregnant women with T1D was reviewed for the study. All of the women attended the Joslin Diabetes Center and Beth Israel Deaconess Medical Center Diabetes in the pregnancy program between 2004 and 2017. Women were divided into 3 groups based on delivery date, 2004 to 2008, 2009 to 2012, and 2013 to 2017. According to the press release, this is the largest database of pregnant women with T1D in the United States.

"Originally, our aim was to look at why women with type 1 diabetes have large birth weight babies, and to determine whether the prevalence of babies born very large has changed over the years in our population,” said Florence Brown, MD, the study co-author and co-director of the Joslin and Beth Israel Deaconess Medical Center Diabetes in Pregnancy Program in Boston, in a press release. “To understand this relationship, it is necessary to understand the influence of a broad number of variables."

According to the press release, A1c levels remained steady in each trimester across the entire study period. Additionally, researchers found that vaginal deliveries increased from 21% in the early part of the study to 29% in later years despite the prevalence of babies with a higher birth weight. Insulin pump use also increased by 23% between 2004 and 2017. Furthermore, CGM rose from no use at the start of the study to 40% during later years.

REFERENCE

Time trends in pregnancy-related outcomes among American women with type 1 diabetes [News Release]. Boston, MA: Joslin Diabetes Center; June 30, 2020. Accessed July 2, 2020.