title: Comparing type 1 and type 2 diabetes in pregnancy- similar conditions or is a separate approach required?
abstract: BACKGROUND
  Pregnancy in women with type 1 (T1DM) or type 2 diabetes (T2DM) is associated with increased risk. These conditions are managed similarly during pregnancy, and compared directly in analyses, however they affect women of different age, body mass index and ethnicity.
  
  
  METHODS
  We assess if differences exist in pregnancy outcomes between T1DM and T2DM by comparing them directly and with matched controls. We also analyze the effect of glycemic control on pregnancy outcomes and analyze predictive variables for poor outcome.
  
  
  RESULTS
  We include 323 women with diabetes and 660 glucose-tolerant controls. T2DM women had higher BMI, age and parity with a shorter duration of diabetes and better glycemic control. Preeclampsia occurred more in women with T1DM only. Rates of elective cesarean section were similar between groups but greater than in controls, emergency cesarean section was increased in women with type 1 diabetes. Maternal morbidity in T1DM was double that of matched controls but T2DM was similar to controls. Babies of mothers with diabetes were more likely to be delivered prematurely. Neonatal hypoglycemia occurred more in T1DM than T2DM and contributed to a higher rate of admission to neonatal intensive care for both groups. Adverse neonatal outcomes including stillbirths and congenital abnormalities were seen in both groups but were more common in T1DM pregnancies. HbA1C values at which these poor outcomes occurred differed between T1 and T2DM.
  
  
  CONCLUSIONS
  Pregnancy outcomes in T1DM and T2DM are different and occur at different levels of glycemia. This should be considered when planning and managing pregnancy and when counseling women.
authors.affiliation: Atlantic Diabetes in Pregnancy Programme, Galway, Ireland. lisaannowens@gmail.com.|Galway Diabetes Research Centre, National University of Ireland, Galway, Ireland. lisaannowens@gmail.com.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Owens
authors.affiliation: Atlantic Diabetes in Pregnancy Programme, Galway, Ireland. jon.sedar@applied.ai.
authors.forename: Jon
authors.initials: J
authors.lastname: Sedar
authors.affiliation: Atlantic Diabetes in Pregnancy Programme, Galway, Ireland. louise.carmody@hse.ie.|Galway Diabetes Research Centre, National University of Ireland, Galway, Ireland. louise.carmody@hse.ie.
authors.forename: Louise
authors.initials: L
authors.lastname: Carmody
authors.affiliation: Atlantic Diabetes in Pregnancy Programme, Galway, Ireland. fidelma.dunne@nuigalway.ie.|Galway Diabetes Research Centre, National University of Ireland, Galway, Ireland. fidelma.dunne@nuigalway.ie.
authors.forename: Fidelma
authors.initials: F
authors.lastname: Dunne
mesh_terms: D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D010298:Parity; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011254:Pregnancy in Diabetics / Q000175:diagnosis / Q000453:epidemiology; D018566:Pregnancy, High-Risk; D013997:Time Factors
chemical_list: D001786:Blood Glucose