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Query: UMLS:C0011854 (type 1 diabetes)
 20,749 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Perinatal mortality and morbidity in infants of diabetic mothers have declined continuously during the past decades, due to advances in prenatal care, obstetric management and intensive neonatal care. This retrospective study reports on complications during pregnancy and fetal outcome in those insulin-dependent-diabetic (IDDM) pregnancies admitted to our institution from 1978 to 1985. Age, weight, prepregnant weight and weight-gain of those patients are compared with normal uncomplicated pregnancies (of the same period). In the diabetic group we noticed a high incidence of abortion (30%) as well as a high frequency of previous stillbirths (19%). In the majority of cases delivery was achieved by the 38th week of gestation the mean birth weight and length being 3,144 g and 48.5 cm respectively. 22% of the cases were delivered by cesarean section. The diagnosis preeclampsia was made in 15 patients, in 4 cases we observed a placental insufficiency, 11 women presented with premature labor and there was one fetal death. 44 newborns (63.8%) had a birthweight between 2,500 g and 4,000 g, 15 infants were below 2,500 g (21.7%), 10 infants weighed more than 4,000 g (14.5%), 5 of them displayed cushingoid features. 3 cases were complicated by hypoglycemia, 3 infants were dystrophic at birth and there was one major congenital anomaly. The incidence of neonatal respiratory distress syndrome was extremely high, 12 milder cases could be managed without ventilation therapy, 4 severe cases had to be given full respiratory support.
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PMID:[Course of pregnancy of insulin-dependent diabetic patients 1978-1985 at the 1st Vienna University gynecologic clinic]. 244 Jan 94

The effect of maternal inhalation of 50 per cent oxygen upon fetal breathing movements was investigated. No significant effect was noted in patients with normal pregnancies or in those complicated by insulin dependent diabetes or mild pre-eclampsia. A significant increase in fetal breathing movements was observed in those pregnancies complicated by either severe pre-eclampsia or fetal growth retardation.
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PMID:Fetal breathing movements and maternal hyperoxia. 743 76

An endogenous sodium pump inhibitor, or digitalis-like factor (DLF), has been postulated to mediate essential hypertension. It may also play a role in preeclampsia. However, studies of this factor in hypertensive pregnancy have not provided consistent findings. Part of this may be due to the absence of subclassification of pregnant women with pregnancy-induced hypertension (PIH) when assessing these parameters. In this study we explored serum DLF and digoxin-like immunoreactive factor (DLIF) in insulin-dependent diabetic (IDDM) women with normotensive pregnancies or PIH, comparing them to each other and to nondiabetic pregnant women. Our results demonstrated that nondiabetic women with preeclampsia (PE, PIH with proteinuria) had significantly increased serum DLF and DLIF compared to normotensive pregnant women (NL BP). Women with transient hypertension of pregnancy (THP, PIH without proteinuria) had intermediate values (DLF. NL BP: 3.3 +/- 0.6, THP: 4.8 +/- 1.1, PE: 7.6 +/- 1.3% inhibition [Na,K]-ATPase, P < .05 ANOVA; DLIF. NL BP: 0.22 +/- 0.02, THP: 0.28 +/- 0.03, PE: 0.35 +/- 0.02 ng digoxin equivalents/mL, P < .05 ANOVA). Pregnant normotensive IDDM women had significantly higher serum DLF and DLIF activity than their nondiabetic counterparts (DLF. non-IDDM NL BP: 3.3 +/- 0.6 v IDDM NL BP: 8.8 +/- 1.2% inhibition [Na,K]-ATPase, P = .0008; DLIF. non-IDDM NL BP: 0.22 +/- 0.02 v IDDM NL BP: 0.31 +/- 0.02 ng digoxin equivalents/mL, P = .005).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Digitalis-like factor and digoxin-like immunoreactive factor in diabetic women with preeclampsia, transient hypertension of pregnancy, and normotensive pregnancy. 873 86

HELLP syndrome (haemolysis, elevated liver function tests and low platelets) is a multiorganic disease and has been described in combination with pre-eclampsia/eclampsia, but even without symptoms of gestosis. There are signs, that HELLP syndrome represents an "acute status of autoimmunity". Since immune mechanisms play a fundamental role together with other factors in the development of type I diabetes mellitus, a combination of autoimmune reactions could explain the development of type I diabetes during an altered immune status. We report on the course of a pregnancy complicated by HELLP syndrome, which developed type I diabetes mellitus in the same pregnancy. A subsequent pregnancy with adequate diabetes therapy was uncomplicated and without recurrence of HELLP syndrome.
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PMID:[HELLP syndrome and manifestation of type I diabetes mellitus in pregnancy]. 785 13

The object of this study was whether improving glycemic control and maintaining normal glycosylated hemoglobin (HbA1c) through pregnancy can reduce the frequency of preeclampsia. One hundred and twenty-three complete medical records of pregnant insulin-dependent diabetics (IDDM) managed at Yale-New Haven Hospital from 1983 to 1993 were reviewed. Serial HbA1c measurements and the occurrence of preeclampsia were recorded. Based on the change of HbA1c values through the pregnancy, glycemic control was categorized into four groups: group 1, high to normal; group 2, high to high; group 3, normal to normal; group 4, normal to high. The association between HbA1c change and the incidence of preeclampsia was analyzed by chi-square test and Fisher's exact test. Among 123 IDDM pregnancies, 40 (32.5%) developed preeclampsia. High HbA1c levels at any time in IDDM pregnancies were associated with an increased incidence of preeclampsia (group 1 or 2 or 4 versus group 3). Reducing HbA1c by improving glycemic control both before and during pregnancy resulted in a significantly lower incidence of pre-eclampsia (group 3 versus groups 1+2+4, p < 0.05). The best strategy for reducing the frequency of preeclampsia in IDDM pregnancies is by improving glycemic control before pregnancy.
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PMID:Strategies for reducing the frequency of preeclampsia in pregnancies with insulin-dependent diabetes mellitus. 886 44

Tumour necrosis factor (TNF) may be relevant to the pathogenesis of both pre-eclampsia and type 1 diabetes, and there is evidence than human TNF alpha responses to stimuli are HLA-DR dependent. To test the hypothesis that pre-eclampsia and diabetes may share a common immunogenetic susceptibility, 92 pre-eclampsia patients were compared with 264 general population controls. The relative frequencies of individual HLA-DR antigens in pre-eclamptics were found to correlate with reported relative TNF alpha responses for those antigens. Moreover, putative high responder HLA-DR1, DR3 and DR4 alleles were significantly (p < 0.001) more frequent in pre-eclampsia patients (79%) than in controls (59%). This hypothesis could explain the weak association between pre-eclampsia and diabetes and may help resolve the apparently conflicting literature on HLA in pre-eclampsia.
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PMID:HLA-dependent TNF secretory response may provide an immunogenetic link between pre-eclampsia and type 1 diabetes mellitus. 887 17

There is little published data on the incidence of remote hypertension, microalbuminuria (a possible marker of remote cardiovascular events) and diabetes following preeclampsia. This is of particular importance in Pacific Island populations as they have a high rate of preeclampsia, non-insulin dependent diabetes and cardiovascular related deaths. The aim of this study was to compare the rate of microalbuminuria and hypertension in 50 Samoan women with past preeclampsia (cases) with 50 Samoan women who did not have past preeclampsia (controls). Forty per cent of cases were hypertensive at follow-up compared to 2% in the control group (p < 0.0001). Microalbuminuria or proteinuria occurred in 40% of women with past preeclampsia and 18% of controls (p < 0.02). Half of the cases with microalbuminuria were hypertensive. No case or control had an elevated fructosamine, suggesting that current diabetes was an unlikely explanation for the microalbuminuria. We conclude that Samoan women with past preeclampsia are at increased risk of developing chronic hypertension and microalbuminuria. The significance of the microalbuminuria after preeclampsia is not known, but it may be a marker of either remote cardiovascular morbidity or non-insulin dependent diabetes. This study raises longterm health implications for women with preeclampsia.
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PMID:What happens to women with preeclampsia? Microalbuminuria and hypertension following preeclampsia. 888 42

The aim of the present study was to examine the influence of pregnancy on deterioration of retinopathy in patients with Type 1 diabetes mellitus. Sixty-five pregnant Type 1 diabetic women attending the University Hospital in Lund were studied retrospectively. The degree of retinopathy, and levels of HbA1c and blood pressure 12 months before, during, and 6 months after pregnancy were compared of those of 56 non-pregnant Type 1 diabetic women matched for age and duration of diabetes. For all patients, sight-threatening deterioration of retinopathy did not differ between the pregnancy group (9/65) and the control group (6/56). Over time, pregnant patients had lower HbA1c levels than controls (p < 0.001). Pregnant patients with sight-threatening deterioration of retinopathy had higher HbA1c levels than those without (p = 0.028 and the decrement in HbA1c between the 6-14th and the 20th week of gestation was more pronounced (p = 0.006). In those patients who developed pre-eclampsia during pregnancy, deterioration of retinopathy ocurred more frequently compared to those without pre-eclampsia (4/8 vs 5/65; p = 0.005). In conclusion, sight-threatening deterioration of retinopathy was not more common during pregnancy in IDDM patients than among age- and duration-matched control patients. In pregnant patients, deterioration of retinopathy was associated with the pregestational degree of metabolic control as well as with a rapidly improved glycaemic control acheived during pregnancy. Among those in whom deterioration occurred during pregnancy, pre-eclampsia was a potent risk factor.
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PMID:Pre-eclampsia is a potent risk factor for deterioration of retinopathy during pregnancy in Type 1 diabetic patients. 945 34

The objective of this study was to evaluate and compare risk factor patterns in association with preeclampsia and gestational hypertension. The data were collected from The Swedish Medical Birth Register and include all nulliparas aged 34 years or less who gave birth at the University Hospital of Uppsala, Sweden, during 1987-1993. Of these 10,666 women, 4.4% developed gestational hypertension, and 5.2% developed preeclampsia. The following risk factors were significantly associated with increased risk of preeclampsia: type 1 diabetes (odds ratio = 5.58, 95% confidence interval 2.72-11.43), gestational diabetes (odds ratio = 3.11, 95% confidence interval 1.61-6.00), and twin birth (odds ratio = 4.17, 95% confidence interval 2.30-7.55). The positive associations between these variables and the risk of gestational hypertension were weaker and nonsignificant. Compared with underweight women (body mass index < 19.8), obese women (body mass index > 29) had increased risks of both gestational hypertension (odds ratio = 4.85, 95% confidence interval 1.97-11.92) and preeclampsia (odds ratio = 5.19, 95% confidence interval 2.35-11.48). Significantly lower risks of preeclampsia and gestational hypertension were observed for women born outside Nordic countries and in association with maternal smoking and summer birth. The similarities in risk factor patterns may indicate similarities in the biologic mechanisms underlying the two conditions.
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PMID:Comparison of risk factors for preeclampsia and gestational hypertension in a population-based cohort study. 962 50

Leptin, the protein encoded by the Ob gene, is produced by the white adipose tissue and by the placenta during pregnancy. Placental leptin production makes a substantial contribution to maternal circulating levels during pregnancy which rapidly decrease and return to normal after delivery. Leptin has been detected in fetal plasma as early as week 18 of gestation, and umbilical leptin concentrations are closely related to birth weight. This has led to the hypothesis that fetal fat mass mainly determines fetal circulating leptin. Placental leptin production is increased in choriocarcinoma, preeclampsia and type 1 diabetes. Estrogens, hypoxia and insulin have been suggested as positive regulators of placental leptin production. Maternal leptinemia might act as a sensor of energy balance during pregnancy. The presence of both leptin and leptin receptors in the placenta suggests that leptin can act by autocrine or endocrine pathways in the human placenta. The roles of fetal leptin and consequences of increased placental leptin production in pathological pregnancies have yet to be elucidated.
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PMID:[Placental leptin and pregnancy pathologies]. 1157 51


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