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Portrait of women with type 1 or type 2 diabetes of childbearing age attending diabetes clinics in Italy: the AMD-Annals initiative

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Abstract

Aim

To describe characteristics relevant in case of an unplanned pregnancy for T1D or T2D women of childbearing age.

Methods

We analyzed the 2011 AMD-Annals dataset, compiling information from 300 clinics (28,840 T1D patients and 532,651 T2D patients). A risk score of unfavorable conditions for pregnancy included HbA1c > 8.0%; BMI ≥ 35; systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg; microalbuminuria/proteinuria; use of statins, ACE inhibitors, ARB; use of diabetes drugs other than metformin/insulin.

Results

The proportion of T2D cases increased from 30.8% (95% CI 29.9–32.4) at age 18–30 years to 67.5% (66.6–68.5) at age 36–45 years. The proportion of women with HbA1c < 7.0% was 20.4% (20.0–20.8) in T1D and 43.4% (42.8–43.9) in T2D women. Furthermore, 47.6% (47.0–48.3) of T1D women and 34.5% (33.9–35.0) of T2D women had HbA1c ≥ 8.0%. The prevalence of obesity (BMI ≥ 30) was sevenfold higher among T2D than T1D women [49.9% (49.4–50.5) and 7.4% (7.2–7.5), respectively]. T2D women were more likely to have hypertension or microalbuminuria than T1D women. Almost half of the T2D women were taking drugs not approved during pregnancy. At least one unfavorable condition for starting a pregnancy was present in 51% of T1D women of childbearing age and in 66.7% of T2D women.

Conclusions

Women with either T1D or T2D of childbearing age in Italy were far from the ideal medical condition for conception. Our data strongly support the need for counseling all women with diabetes about pregnancy planning.

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Acknowledgements

The authors wish to acknowledge the contribution of all professionals of the diabetes centers participating to the AMD-Annals initiative and to thank the Fondazione AMD for providing the opportunity to analyze the 2011 AMD-Annals dataset for the purpose of this study.

Author information

Author notes

  1. Marina Scavini and Maria Chiara Rossi have contributed equally to this work.

Authors and Affiliations

  1. Diabetes Research Institute, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    Marina Scavini, Chiara Molinari & Nicoletta Dozio

  2. Vita-Salute San Raffaele University, Milan, Italy

    Marina Scavini & Nicoletta Dozio

  3. Center for Outcomes Research and Clinical Epidemiology (Coresearch), Pescara, Italy

    Maria Chiara Rossi, Marco Scardapane & Antonio Nicolucci

  4. Department of Internal Medicine, Montecchio Hospital, AUSL of Reggio Emilia, Reggio Emilia, Italy

    Valeria Manicardi

  5. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

    Giuseppina Russo

  6. Diabetes Unit, AUSL Romagna, Ravenna, Italy

    Paolo Di Bartolo

  7. Diabetes and Metabolism Unit, ASL Turin 5, Chieri, Italy

    Carlo B. Giorda

  8. UOS Integrating Primary and Specialist Care, ASST Nord Milano, Milan, Italy

    Nicoletta Musacchio

  9. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Centro de Investigación Biomedica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain

    Antonio Ceriello

  10. Department of Cardiovascular and Metabolic Diseases, IRCCS Multimedica, Sesto San Giovanni, Italy

    Antonio Ceriello

  11. Diabetes, Endocrine and Metabolic Diseases Unit, IRCCS Centro Cardiologico Monzino, Milan, Italy

    Stefano Genovese

Authors
  1. Marina Scavini
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  2. Maria Chiara Rossi
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  3. Marco Scardapane
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  4. Antonio Nicolucci
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  6. Giuseppina Russo
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  7. Paolo Di Bartolo
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  8. Carlo B. Giorda
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  9. Nicoletta Musacchio
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  10. Antonio Ceriello
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  11. Stefano Genovese
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  12. Chiara Molinari
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  13. Nicoletta Dozio
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Consortia

AMD-Annals Study Group

Contributions

MS and ND planned the study and wrote the manuscript; MCR supervised data analysis and contributed to the writing of the manuscript; MS compiled the dataset and analyzed the data; AN supervised data analysis and critically reviewed the manuscript; VM, GR and SG critically reviewed the manuscript; PDB, CG, NM, AC are guarantor of the AMD-Annals Initiative and critically reviewed the manuscript; CM reviewed the literature and contributed to the writing of the manuscript.

Corresponding author

Correspondence to Marina Scavini.

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Conflict of interest

The authors have no conflict of interest to disclose regarding the topic of this manuscript.

Human and animal rights

The study reported in this article is a retrospective observational study on patients with diabetes. None of the authors had direct contact with the patients whose data were deidentified at the time of collection by individual diabetes clinics.

Informed consent

For this type of study written informed consent is not required.

Additional information

Managed by Antonio Secchi.

Electronic supplementary material

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Scavini, M., Rossi, M.C., Scardapane, M. et al. Portrait of women with type 1 or type 2 diabetes of childbearing age attending diabetes clinics in Italy: the AMD-Annals initiative. Acta Diabetol 55, 193–199 (2018). https://doi.org/10.1007/s00592-017-1076-9

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  • DOI: https://doi.org/10.1007/s00592-017-1076-9

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