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Semin Reprod Med
DOI: 10.1055/s-0044-1791704
Review Article

Type 1 Diabetes and Pregnancy: Challenges in Glycemic Control and Maternal–Fetal Outcomes

Tejumola Apata
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Rochester Medical Center, Rochester, New York
,
Dennis Samuel
2   Division of Endocrinology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
,
Laticia Valle
2   Division of Endocrinology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
,
Sarah D. Crimmins 
1   Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Rochester Medical Center, Rochester, New York
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Abstract

Managing type 1 diabetes during pregnancy presents significant challenges due to physiological and hormonal changes. These factors contribute to major changes in insulin sensitivity, complicating efforts to achieve and sustain optimal blood glucose levels. Poorly controlled glucose levels during pregnancy can result in diabetic embryopathy and elevate the risks of maternal complications such as hypertensive disorders and diabetic ketoacidosis. Fetal complications may include preterm birth, fetal demise, and admission to neonatal intensive care units. It is essential to recognize that there is no universal approach to managing glycemic control in pregnant women with T1DM and care should be individualized. Effective management requires a multidisciplinary approach involving regular monitoring, adjustments in insulin therapy, dietary modifications, and consistent prenatal care. Continuous glucose monitoring has emerged as a valuable tool for real-time glucose monitoring, facilitating tighter glycemic control. Education and support for self-management are important in addressing these challenges. Future developments in technology and personalized approaches to care show promising potential for advancing diabetes management during pregnancy. This provides a comprehensive overview of current literature on the challenges with the management of T1DM during pregnancy, focusing on its impact on maternal and neonatal outcomes and highlighting effective strategies for achieving optimal glycemic control.

Keywords

type 1 diabetes - maternal outcomes - fetal complications - glucose control - diabetes care


Publication History

Article published online:
08 October 2024

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