Factors determining insulin requirements in women with type 1 diabetes mellitus during pregnancy: a review

Author:

Achong Naomi12,McIntyre Harold David2,Callaway Leonie12

Affiliation:

1. Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia

2. The University of Queensland, Raymond Tce, South Brisbane, Queensland, Australia

Abstract

Most women with type 1 diabetes mellitus (T1DM) have increased insulin requirements during pregnancy. However, a minority of women have a fall in insulin requirements. When this occurs in late gestation, it often provokes concern regarding possible compromise of the feto-placental unit. In some centres, this is considered as an indication for delivery, including premature delivery. There are, however, many other factors that affect insulin requirements in pregnancy in women with type 1 diabetes mellitus and the decline in insulin requirements may represent a variant of normal pregnancy. If there is no underlying pathological process, expedited delivery in these women is not warranted and confers increased risks to the newborn. We will explore the factors affecting insulin requirements in gestation in this review. We will also discuss some novel concepts regarding beta-cell function in pregnancy.

Publisher

SAGE Publications

Subject

Obstetrics and Gynaecology

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