PREGNANCY OUTCOMES IN WOMEN WITH TYPE 1 DIABETES TREATED WITH LONG ACTING INSULIN ANALOGS. A CASE CONTROL STUDY

Summary. The aim was to evaluate and compare the pregnancy outcome in women with type1 diabetes (T1D) intensively treated with long acting insulin or insulin analogs. A prospective two-year case control study in ninety pregnant women with T1D was performed. The intensio ed treatment consisted of insulin aspart as bolus insulin and long acting insulin as basal. Women were divided into three groups according to the basal insulin: n 1 =30 treated with NPH insulin, n 2 =30 treated with insulin detemir and n 3 =30 treated with insulin glargine. Participants were matched for age, duration of diabetes, BMI, HbA1c before pregnancy parity, number of previous pregnancies and abortions. Metabolic control, diabetic complications, severe hypoglycemic episodes and pregnancy induced hypertension and preeclampsia were registered. Perinatal mortality, stillbirth, macrosomia, weeks and route of delivery and neonatal complications were also recorded. Statistical methods: ANOVA – with multiple comparison and chi square test have been used. No statistically signio cant difference in mean values for age, diabetes duration, BMI, parity, and number of previous pregnancies. No differences were observed in pre-prandial, postprandial glucose and HbA1c levels in early pregnancy (HbA1c n 1 = 7.3 ± 0.8%, n 2 = 6.9 ± 0.9%, n 3 = 7.1 ± 0.8%, P = 0.7). No differences were observed in postprandial glucose and Hba1c in late pregnancy (HbA1c n 1 = 7.8 ± 0.3%, n 2 = 7.3 ± 0.6%, n 3 = 7.7 ± 0.7%, P = 0.06) as well. The level of preprandial glucose in late pregnancy was lowest in o rst group (n 1 = 4.5 ± 1.4 mmol/l, n 2 = 6.6 ± 1.1 mmol/l, n 3 = 6.9 ± 0.8 mmol/l, P = 0.0001). The doses of short acting insulin were signio cantly higher in the o rst group in early (n 1 = 25.9 ± 34.5 U/kg, n 2 = 17.0 ± 25.3 U/kg, n 3 = 19.6 ± 26.7%, P = 0.004) and in late pregnancy (n 1 = 41.1 ± 20.0 U/kg n 2 = 26.1 ± 12.9 U/kg, n 3 = 21.9 ± 10.1 U/kg, P = 0.0001). There were no differences in the dose of long acting insulin in early pregnancy between the groups, but in late pregnancy the dose in n 1 group was statistically lower in comparison to the other two groups (n 1 = 16.0 ± 6.8 U/kg n 2 =