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Preeclampsia, Diabetic Nephropathy Rates Linked


 

Among women with type 1 diabetes whose pregnancies were managed at one clinic in Finland, those who had a history of preeclampsia went on to have a higher rate of diabetic nephropathy in the following years than did those with normotensive pregnancies.

In the report, researcher Daniel Gordin and colleagues at Helsinki University Central Hospital reported findings for 203 women with type 1 diabetes who had been pregnant between 1988 and 1996 and who were followed an average of 11 years within the nationwide, multicenter Finnish Diabetic Nephropathy Study.

For purposes of the study, diabetic nephropathy was defined as microalbuminuria, macroalbuminuria, or end-stage renal disease.

Among the women with history of preeclampsia, the rate of diabetic nephropathy at follow-up was 42%, versus 9% for those without such history (Diabetologia 2007 [Epub ahead of print doi 10.1007/s00125-006-0544-5

Women with pregnancy-induced hypertension, however, were not at significantly increased risk of microvascular disease, compared with normotensive women (10.3% vs. 8.9%).

Diabetic nephropathy at follow-up was also predicted by poor glycemic control during pregnancy. Hemoglobin A1c levels in each trimester significantly correlated with kidney disease.

These results warrant more intensive monitoring of women with type 1 diabetes and a history of preeclampsia, as well as special emphasis on early detection of microalbuminuria, the investigators concluded.

In addition, β€œan early start to renoprotective medication in type 1 diabetic women with prior preeclampsia could be beneficial,” they suggested.

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