Impact of pregnancy on the progression of diabetic retinopathy in Type 1 diabetes

Temple, Rosemary; Aldridge, Valerie; Sampson, Mike; Greenwood, R.; Heyburn, PJ; Glenn, A.

doi:10.1046/j.1464-5491.2001.00535.x

Cited by 122 publications

(90 citation statements)

References 17 publications

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“…In early pregnancy the majority of women had no or mild retinal changes, which is comparable to previous reports on women with type 1 diabetes with similar duration of diabetes [14,15]. The risk of progression of diabetic retinopathy in women with type 2 diabetes in the current study seems to be lower than in women with type 1 diabetes [15].…”

Section: Discussionsupporting

confidence: 76%

“…The risk of progression of diabetic retinopathy in women with type 2 diabetes in the current study seems to be lower than in women with type 1 diabetes [15]. However, since sight-threatening deterioration of diabetic retinopathy occurred in one pregnant women with type 2 diabetes in the current study and in a woman with type 2 diabetes described by us in a previous cohort [4], as well as in a Japanese study of women with type 2 diabetes [2], the risk of progression cannot be ignored.…”

Section: Discussionmentioning

confidence: 78%

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Progression of diabetic retinopathy during pregnancy in women with type 2 diabetes

et al. 2010

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Aims/hypothesis We studied the progression of diabetic retinopathy during pregnancy in women with type 2 diabetes. Methods Fundus photography was performed at median 10 (range 6-21) and 28 (27-37) gestational weeks in 80 of 110 (73%) consecutively referred pregnant women with type 2 diabetes. Diabetic retinopathy was classified in five stages.Progression was defined as at least one stage of deterioration of diabetic retinopathy and/or development of macular oedema on at least one eye between the two examinations. Macular oedema was defined as retinal thickening and/or hard exudates within a diameter of 1,500 µm in the macula area. Results Diabetic retinopathy, mainly mild, was present in 11 (14%) women in early pregnancy. Median duration of diabetes was 3 years (range 0-16 years). At baseline, HbA 1c was 6.4% (1.0) (mean [SD]), systolic BP 121 (13) and diastolic BP 72 (9) mmHg. Prior to pregnancy, 22 (28%) women had been on insulin treatment. During pregnancy 74 women (93%) were treated with insulin and 11 (14%) with antihypertensive medication. Progression of diabetic retinopathy was observed in 11 (14%) women. Progression was mainly mild, but one woman with poor glycaemic control and uncontrolled hypertension progressed from mild retinopathy to sight-threatening retinopathy with proliferations, clinically significant macular oedema and impaired vision in both eyes. Progression of diabetic retinopathy was associated with a longer duration of diabetes (p=0.03) and insulin treatment before pregnancy (p=0.004). Conclusions/interpretation Despite a low risk of progression of retinopathy in pregnant women with type 2 diabetes, sight-threatening deterioration did occur.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 78%

Progression of diabetic retinopathy during pregnancy in women with type 2 diabetes

et al. 2010

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“…Pacientes com retinopatia diabética não proliferativa moderada deveriam ser examinadas de quatro em quatro semanas. Normalmente, a progressão da retinopatia piora no final do segundo trimestre (36) . As recomendações atuais para o tratamento incluem: fotocoagulação em gestantes com retinopatia diabética não proliferativa grave.…”

Section: A -Retinopatia Diabéticaunclassified

Mudanças oculares durante a gestação

Gouveia¹,

Conceição

Morales³

2009

Arq. Bras. Oftalmol.

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“…The risk of progression is dependent on duration of diabetes, degree of retinopathy, previous laser therapy and glycaemic control. 28,29 In the non-pregnant state, the progression of diabetic nephropathy is slowed through tight glycaemic control, treatment with ACE-Is and tight blood pressure control. The need to discontinue ACE inhibition during pregnancy, together with the physiological increase in glomerular filtration rate during pregnancy, contribute to the frequently observed increase in microalbuminuria.…”

Section: Optimizing-associated Conditionsmentioning

confidence: 99%

Type 2 diabetes in pregnancy: importance of optimized care before, during and after pregnancy

Keely

2008

Obstet Med

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Summary: Women with Type 2 diabetes (T2DM) are an increasingly important part of the practice of obstetric medicine. The rising rates of obesity and advanced maternal age have resulted in a surge in the number of pregnant women with T2DM. The hyperglycaemia and associated conditions of the metabolic syndrome lead to poor obstetric outcome and impact on the long-term health of the mother and offspring. It is essential that women and care-givers recognize the seriousness of T2DM in pregnancy and strive to improve prepregnancy care, obstetric outcome and the long-term health of both the mother and child.

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Impact of pregnancy on the progression of diabetic retinopathy in Type 1 diabetes

Cited by 122 publications

References 17 publications

Progression of diabetic retinopathy during pregnancy in women with type 2 diabetes

Progression of diabetic retinopathy during pregnancy in women with type 2 diabetes

Mudanças oculares durante a gestação

Type 2 diabetes in pregnancy: importance of optimized care before, during and after pregnancy

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