title: Postpartum metabolic control in a cohort of women with type 1 diabetes.
abstract: OBJECTIVE
  Pregnancy in women with type 1 diabetes (T1D) involves greater risks as compared to non-diabetic women, but less information is available about blood glucose and weight control after delivery. Our aim was to evaluate the postpartum metabolic profile (blood glucose and weight control) of women with T1D and the factors related to those metabolic outcomes.
  
  
  METHODS
  A retrospective, observational study of 36 women with T1D during pregnancy and for up to one year after delivery.
  
  
  RESULTS
  Fifty percent of patients attended a preconceptional planning program (PPP), and 44.4% of women were treated with continuous subcutaneous insulin infusion. Mean preconceptional HbA1c and body mass index (BMI) were 7.2±1.2% and 23.8±5.0 respectively. In the total cohort, blood glucose control significantly worsened one year after delivery (HbA1c: 7.2±1.2 vs 7.6±1.2%, P<0.001). Lower preconceptional HbA1c values were found in patients who attended PPP (6.6±0.5 vs. 7.8±1.4%; P=0.02), and were maintained for one year after delivery. No differences were found in body mass index (BMI) from the pregestational period to one year after delivery in any of two groups (No PPP 22.5±4.6 vs 23.2±4.8, P=0.078; PPP 25.4±3.4 vs 25.5±3.4 kg/m(2), P=0.947). Preconceptional HbA1c was shown to be the most important determinant of metabolic control (β=0.962, p<0.001) and weight one year after delivery (β=0.524, p=0.025) and weight gain during pregnancy (β=0.633, p=0.004).
  
  
  CONCLUSIONS
  Pregnant women with T1D return to prepregnancy body weight one year after delivery, especially those with lower HbA1c levels and BMI before pregnancy. However, blood glucose control deteriorates after delivery, suggesting the need for changes in clinical practice after delivery.
authors.affiliation: Diabetes Unit, Endocrinology and Nutrition Service, Hospital Clínic i Universitari de Barcelona, Spain. Electronic address: cmquiros@clinic.ub.es.
authors.forename: Carmen
authors.initials: C
authors.lastname: Quirós
authors.affiliation: Diabetes Unit, Endocrinology and Nutrition Service, Hospital Clínic i Universitari de Barcelona, Spain.
authors.forename: Ioana
authors.initials: I
authors.lastname: Patrascioiu
authors.affiliation: Diabetes Unit, Endocrinology and Nutrition Service, Hospital Clínic i Universitari de Barcelona, Spain.
authors.forename: Verónica
authors.initials: V
authors.lastname: Perea
authors.affiliation: Obstetric Unit, Hospital Clínic i Universitari de Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Bellart
authors.affiliation: Diabetes Unit, Endocrinology and Nutrition Service, Hospital Clínic i Universitari de Barcelona, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Conget
authors.affiliation: Diabetes Unit, Endocrinology and Nutrition Service, Hospital Clínic i Universitari de Barcelona, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Vinagre
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D001835:Body Weight; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy / Q000378:metabolism; D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D049590:Postpartum Period / Q000097:blood* / Q000378:metabolism; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Body weight; Diabetes Mellitus tipo 1; Periodo posparto; Peso corporal; Postpartum period; Type 1 diabetes mellitus