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For the First Time, Study Identifies Time Trends in Pregnancy-Related Outcomes Among American Women with Type 1 Diabetes

BOSTON – (June 30, 2020) – Researchers from the Joslin Diabetes Center investigated time trends in pregnancy-related outcomes among women with type 1 diabetes between 2004 and 2017, and found that the percentage of mothers with excess weight gain during pregnancy as well as the use of insulin pumps and CGMs increased significantly, while the prevalence of nephropathy fell dramatically to zero. Furthermore, the research highlights a trend toward increased pre-pregnancy obesity in this population, but the percentage of very large babies born remained the same. The research is published online on June 2, 2020 by the Journal of Perinatology.

The percentage of women with type 1 diabetes before pregnancy has climbed nearly 40% in the past two decades, according to the Centers for Disease Control and Prevention.

“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,” says Florence Brown, MD, study coauthor and Co-Director of the Joslin and Beth Israel Deaconess Medical Center Diabetes in Pregnancy Program in Boston. “To understand this relationship, it is necessary to understand the influence of a broad number of variables.”

For the study, researchers reviewed medical records of 700 pregnant women with type 1 diabetes who attended the Joslin Diabetes Center and Beth Israel Deaconess Medical Center Diabetes in Pregnancy Program between 2004 and 2017. Currently, this is the largest U.S. database on pregnant women with type 1 diabetes.

Researchers analyzed data on treatment, delivery and neonatal outcomes, as well as the mothers’ glucose levels, gestational weight gain and other maternal factors that impact outcomes in pregnancy. To calculate trends in these areas over time, patients were divided into three groups based on their delivery date: 2004 to 2008; 2009 to 2012; and 2013 to 2017. Researchers then compared changes over these time periods. The study revealed:

These findings are important because they are a stepping stone to our next analysis, says Brown. “This is the first time we’ve really been able to paint a big picture, and identify the clues as to which factors may be associated with large birthweight, such as maternal BMI, maternal gestational weight gain and A1c levels.”

Study co-authors include Sarit Helman, Tamarra M. James-Todd, Zifan Wang, Andrea Bellavia, Jennifer A. Wyckoff, Shanti Serdy, Elizabeth Halprin, Karen O’Brien, Tamara Takoudes, Munish Gupta and Thomas F. McElrath.

The study was supported with a grant from the National Institutes of Health (NIH).

About Joslin Diabetes Center

Joslin Diabetes Center is world-renowned for its deep expertise in diabetes treatment and research. Joslin is dedicated to finding a cure for diabetes and ensuring that people with diabetes live long, healthy lives.  We develop and disseminate innovative patient therapies and scientific discoveries throughout the world. Joslin is an independent, non-profit institution affiliated with Harvard Medical School, and one of only 16 NIH-designated Diabetes Research Centers in the U.S.

For more information, visit www.joslin.org or follow @joslindiabetes | One Joslin Place, Boston, MA 617-309-2400

 

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