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Item
#7
Risk Factors Identified For
Severe Hypoglycemia During First Trimester Of Type I Diabetic
Pregnancy
Severe hypoglycemia occurred almost three times more often in the
first trimester
Several factors associated with the increased risk of severe
hypoglycemia during the first trimester of pregnancy have been
identified in type I diabetic women.
Investigators from the University Medical Center at Utrecht
University in Utrecht, the Netherlands, found that history of
severe hypoglycemia before gestation, longer duration of diabetes,
hemoglobin A1c (HbA1c) level less than or
equal to 6.5 percent and higher total daily insulin dose were all
predictive for severe hypoglycemia in the first trimester of type
I diabetic pregnancy.
These results are from a longitudinal cohort survey of 278
pregnant women with type 1 diabetes. Frequencies of severe
hypoglycemia and hypoglycemic coma, general characteristics,
hypoglycemic awareness, blood glucose symptom threshold and
Hypoglycemic Fear Survey were assessed at inclusion into the study
and at 17 weeks of gestation.
Results showed that, overall, severe hypoglycemia occurred almost
three times more often in the first trimester versus the four
months before gestation (2.6 ± 6.3 versus 0.9 ± 2.4 episodes). The
proportion of women affected by severe hypoglycemia increased from
25 to 41 percent during the first trimester.
Further research, according to the investigators, should address
the benefits that strict glycemic control has in balancing the
increased risk of severe hypoglycemia in early type I diabetic
pregnancy.
Diabetes Care 2002; 25(3): 554-559
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Glycemic control may prevent or even reverse deterioration in
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