Older depressed patients with diabetes who receive additional intervention for their depression are half as likely to die within 5 years as similar patients who not provided this intervention
In one respect, however, the two groups did not differ. "It is particularly alarming that during the critical stage of early pregnancy, women with diabetes on average spend only 50% of 12 h/day with blood glucose levels in the euglycemic range."
Dr. Helen R. Murphy at Ipswich Hospital NHS Trust in the UK and colleagues analyzed data from continuous glucose monitoring during 7 days in each trimester of pregnancy in 40 women with pregestational type 1 diabetes and 17 women with type 2 diabetes.
The researchers found that time spent within the euglycemic range (blood glucose 70-140 mg/dL) increased as gestation advanced, and that women with type 2 diabetes spent about a third more time euglycemic than women with type 1 diabetes.
Time spent hyperglycemic (> 140 mg/dL) decreased as gestation advanced, and women with type 2 diabetes spent only two-thirds as much time hyperglycemic as women with type 1 (p = 0.005). Type 2 diabetes was also associated with shorter durations of extreme hyperglycemia (> 200 mg/dL).
Although the proportion of time spent hypoglycemic (< 70 mg/dL) did not change significantly over gestation, women with type 1 diabetes spent more time hypoglycemic than did those with type 2 diabetes.
Dr. Murphy and colleagues concluded that, "Strikingly, the data highlight just how difficult it is to reach current targets for euglycemia, particularly for women with type 1 diabetes,"
They add, "These data are important for all clinicians seeking to limit hypoglycemia and optimize maternal glycemic control in daily practice, as well as researchers seeking to improve therapeutic interventions aimed at achieving normoglycemia during pregnancy."
Diabetes Care 2007;30:2785-2791.
DID YOU KNOW:
Insulin Reduces Mortality in Patients With ACS and Hyperglycemia: Insulin treatment of nondiabetic patients with acute coronary syndrome (ACS) and hyperglycemia is associated with reduced risk of death in the first 30 days. Compared with patients treated with insulin, those who were not treated had a 56% higher risk of death at 7 days and a 51% higher risk of death at 30 days after adjustment for age, gender, pre-existing heart or renal failure, admission blood glucose, presence of ST elevation infarction, and history of previous angina or myocardial infarction. See This Week’s Item #7