Pregnancy outcomes in women with type 1 and type 2 diabetes mellitus in a retrospective multi-institutional study in Japan

Sato, Takahiro; Sugiyama, Takashi; Michiyo, Kurakata; Saito, Masatoshi; Sugawara, Junichi; Yaegashi, Nobuo; Sagawa, Norimasa; Sanaka, Mayumi; Akazawa, Shoichi; Anazawa, Sonoko; Waguri, Masako; Sameshima, Hiroshi; Hiramatsu, Yuji; Toyoda, Nagayasu

doi:10.1507/endocrj.ej14-0140

Cited by 20 publications

(14 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The differences in patient backgrounds between women with T1D and T2D were consistent with a previous report in Japan [ 7 ]. Duration of diabetes was longer and incidence of retinopathy was higher in women with T1D, while pre-gestational BMI and incidence of obesity were higher in those with T2D.…”

Section: Discussionsupporting

confidence: 91%

“…The present findings were in line with these previous reports, suggesting that weight control before pregnancy is important for obese patients with T2D in order to reduce the risk of perinatal complications. Omori et al reported that perinatal outcome was worse in Japanese women with T2D compared with those with T1D in 1994 [ 17 ], while a more recent study in Japan showed comparable perinatal outcomes between women with T1D and T2D [ 7 ], suggesting an improvement of perinatal outcome in women with T2D possibly due to improvement of the pre-conception management of T2D. Recently, advances in insulin therapy have also facilitated optimal glycemic control during pregnancy in women with T2D.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Association of Maternal Factors with Perinatal Complications in Pregnancies Complicated with Diabetes: A Single-Center Retrospective Analysis

Endo

Saisho

Miyakoshi

et al. 2018

JCM

View full text Add to dashboard Cite

Objective: The aim of this study was to clarify the association of maternal factors with perinatal complications in pregnancies complicated with type 1 (T1D) or type 2 diabetes (T2D). Methods: We conducted a retrospective chart review and enrolled 26 Japanese pregnant women with diabetes who received perinatal care at our hospital between 2008 and 2015. Perinatal complications were defined as one or more of the following: miscarriage, fetal death, fetal dysfunction, fetal structural anomaly, small-for-gestational age, large-for-gestational age (LGA), premature birth, neonatal hypoglycemia, pregnancy-induced hypertension (PIH), deterioration of maternal kidney function, and urgent Caesarean section (CS). The associations between perinatal complications and maternal factors were examined. Results: Approximately 70% and 50% of women with T1D and T2D experienced perinatal complications, respectively. LGA, neonatal hypoglycemia, and urgent CS were major perinatal complications in women with T1D, while PIH and urgent CS were major complications in those with T2D. In women with T1D, pre-gestational HbA1c was significantly higher in women with perinatal complications than in those without. In women with T2D, pre-gestational body mass index was significantly higher in women with perinatal complications than in those without. Conclusions: These findings suggest that while pre-gestational glycemic control remains the most important issue in women with T1D, pre-gestational weight control in addition to glycemic control should be greater emphasized in women with T2D to reduce the risk of perinatal complications.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Association of Maternal Factors with Perinatal Complications in Pregnancies Complicated with Diabetes: A Single-Center Retrospective Analysis

Endo

Saisho

Miyakoshi

et al. 2018

JCM

View full text Add to dashboard Cite

show abstract

“…Compared with the general pregnant population, women with T2DM tend to have worse pregnancy outcomes [7]. Women with T2DM deliver earlier and are at an increased risk of injuries from delivering a large infant [8].…”

Section: Animal Model and Tissue Collectionmentioning

confidence: 99%

High insulin impaired ovarian function in early pregnant mice and the role of autophagy in this process

et al. 2017

Endocr J

View full text Add to dashboard Cite

METABOLIC DISORDERS, such as PCOS (polycystic ovary syndrome) and T2DM (type 2 diabetes mellitus), are reported to be associated with high miscarriage rates, decreased pregnancy rates, and low live birth rates [1]. PCOS and T2DM are characterized by hyperinsulinemia [2]. PCOS is an endocrine and metabolic disorder with a prevalence ranging from 5 to 13% in women of reproductive age. Moreover, PCOS is often accompanied by menstrual dysfunction, anovulaHigh insulin impaired ovarian function in early pregnant mice and the role of autophagy in this process Abstract. Metabolic disorders, such as PCOS (polycystic ovarian syndrome) and T2DM (type 2 diabetes mellitus), are associated with menstrual dysfunction, anovulation, infertility, and early pregnancy loss. Ovarian dysfunction is not only related to low pregnancy rates but also to the increased risk of miscarriage. Women with PCOS or T2DM, characterized by hyperinsulinemia, commonly experience ovarian dysfunction. In this study, we first explored whether high insulin levels directly affected ovarian functioning during embryo implantation. Mice in the insulin-treated group were given a subcutaneous injection of human recombinant insulin. After insulin treatment, serum levels of E2 (estrogen), PROG (progesterone), LH (luteinizing hormone), and FSH (follicle-stimulating hormone) were obviously lower, and there was a significant decrement of ovarian GDF9 (growth differentiation factor 9) mRNA. H&E (hematoxylin and eosin) staining showed a greater number of immature follicles and less luteinization in the insulin group. Further autophagy was studied in this process. A significant increase of P62 (SQSTM1/Sequestosome1) and a decrease of Cathepsin B, BECN1 (Beclin 1), and ULK1 (Unc-51-like kinase 1) mRNA in ovary was found in the insulin group. Western blot analysis showed that the expressions of LC3 (microtubule-associated protein 1 light chain 3), BECN1, and Cathepsin B proteins in ovaries from insulin group were obviously reduced, while P62 proteins were significantly increased. All these results illustrated that insulin could directly impair ovarian function during embryo implantation and the imbalance of ovarian autophagy due to insulin. Autophagy could enhance the impaired ovarian function results from insulin.

show abstract

“…In another study, multiple logistic regression analyses of pregnancy outcome among Japanese women with T1DM and T2DM revealed that the incidence of HDP (gestational hypertension or preeclampsia) and preeclampsia among women with T1DM (11.1% and 8.7%, respectively) were similar to those among women with T2DM (13.3% and 12.1%, respectively). The incidences of macrosomia, light-for-dates, and small for dates among infants of women with T1DM (4.6%, 30.2%, and 11.7%, respectively) were similar to those among women with T2DM (5.0%, 32.8%, and 15.7%, respectively) [30]. In the present study, the mean birth weight among women with T1DM was significantly higher than that among those with T2DM; however, the incidence of FGR and the mean birth weight SD among women with T1DM were similar to that among women with T2DM.…”

Section: Discussionmentioning

confidence: 64%

Glycemic control and fetal growth of women with diabetes mellitus and subsequent hypertensive disorders of pregnancy

et al. 2020

View full text Add to dashboard Cite

Pregnant women with diabetes mellitus (DM) are at high risk for hypertensive disorder of pregnancy (HDP). Women with poor control DM sometimes have heavy-for-dates infants. However, women with HDP sometimes have light-for-dates infants. We aim to clarify the relationship between glycemic control and fetal growth in women with DM and/or subsequent HDP. Of 7893 women gave singleton birth at or after 22 gestational weeks, we enrolled 154 women with type 1 DM (T1DM) or type 2 DM (T2DM) whose infants did not have fetal abnormalities. Among women with T1DM or T2DM, characteristics of the three groups (with HDP, without HDP, and with chronic hypertension [CH]) were compared. No women with T1DM had CH, but 19 (17.4%) of 109 with T2DM did. HDP incidence was similar between women with T1DM (22.2%) and T2DM without CH (16.7%). Among women with T1DM, the incidences of fetal growth restriction (FGR) with and without HDP were similar. However, among women with T2DM without CH, this incidence was significantly higher among those with HDP (33.3%) than among those without HDP (5.3%), was significantly more common with HbA1c levels at first trimester � 7.2% (33.3%) than with those < 7.2% (5.6%), and significantly more numerous without pre-pregnancy therapies for DM (23.3%) than with them (3.3%). Among women with T2DM and HDP, those with FGR had smaller placenta SDs and higher insulin dosages at delivery than those without light-for-dates. In multivariate analysis, the presence of diabetic nephropathy was a predictor of T1DM and HDP (P = 0.0105), whereas HbA1c levels � 7.2% before pregnancy was a predictor of T2DM and HDP (P = 0.0009). Insulin dosage � 50U/day at delivery (P = 0.0297) and the presence of HDP (P = 0.0116) independently predicted T2DM, HDP, and FGR development. Insufficient pre-pregnancy treatment of DM increased the risk of HDP.

show abstract

Pregnancy outcomes in women with type 1 and type 2 diabetes mellitus in a retrospective multi-institutional study in Japan

Cited by 20 publications

References 23 publications

Association of Maternal Factors with Perinatal Complications in Pregnancies Complicated with Diabetes: A Single-Center Retrospective Analysis

Association of Maternal Factors with Perinatal Complications in Pregnancies Complicated with Diabetes: A Single-Center Retrospective Analysis

High insulin impaired ovarian function in early pregnant mice and the role of autophagy in this process

Glycemic control and fetal growth of women with diabetes mellitus and subsequent hypertensive disorders of pregnancy

Contact Info

Product

Resources

About