Association of pre‐pregnancy BMI and postpartum weight retention with postpartum HbA1c among women with Type 1 diabetes. Issue 2 (19th November 2014)

• Record Type: Journal Article
• Authors: Huang, T.; Brown, F. M.; Curran, A.; James‐Todd, T.
• Is Part Of: Diabetic medicine. Volume 32:Issue 2(2015:Feb.)
• Page Start: 181
• Page End: 188
• Publication Date: 2014-11-19
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12617
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" id="dme12617-abs-0001"> <title>Abstract</title> <sec id="dme12617-sec-0001" sec-type="section"> <title>Aim</title> <p>To examine the association of pre‐pregnancy BMI and postpartum weight retention with postpartum HbA<sub>1c</sub> levels in women with Type 1 diabetes.</p> </sec> <sec id="dme12617-sec-0002" sec-type="section"> <title>Methods</title> <p>We longitudinally evaluated 136 women with Type 1 diabetes who received prenatal, pregnancy, and postpartum care through Joslin Diabetes Center's Diabetes and Pregnancy Program between 2004 and 2009. Weight, BMI and HbA<sub>1c</sub> concentrations were assessed before the index pregnancy and repeatedly monitored after delivery until 12 months postpartum. We used linear mixed models to assess the association of postpartum HbA<sub>1c</sub> with pre‐pregnancy BMI and postpartum weight retention.</p> </sec> <sec id="dme12617-sec-0003" sec-type="section"> <title>Results</title> <p>The mean HbA<sub>1c</sub> concentration increased from 49 mmol/mol (6.6%) at 6 weeks postpartum to 58 mmol/mol (7.5%) by 10 months postpartum, a level similar to the mean pre‐pregnancy HbA<sub>1c</sub> concentration. Postpartum weight retention showed a linearly decreasing trend of 0.06 kg/week (<italic>P </italic><<italic> </italic>0.0001), with −0.1 kg average postpartum weight retention by 1 year postpartum. Compared with women with a pre‐pregnancy BMI ≥ 25 kg/m<sup>2</sup>, women with a lower pre‐pregnancy BMI maintained a 3.4 mmol/mol (0.31%) lower HbA<sub>1c</sub> concentration, after adjusting for several sociodemographic, reproductive and diabetes‐related factors (<italic>P </italic>=<italic> </italic>0.03). There was a suggestion of a time‐varying positive association between HbA<sub>1c</sub> and postpartum weight retention, with the most significant difference of 3.7 mmol/mol (0.34%; <italic>P </italic>=<italic> </italic>0.05) at 30 weeks postpartum among women with postpartum weight retention ≥ 5 kg vs those with postpartum weight retention < 5 kg.</p> </sec> <sec id="dme12617-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Pre‐pregnancy BMI and postpartum weight retention were positively associated with HbA<sub>1c</sub> during the first postpartum year in women with Type 1 diabetes. Interventions to modify the behaviours associated with these body weight factors before pregnancy and after delivery may help women with Type 1 diabetes maintain good glycaemic control after pregnancy.</p> </sec> </abstract>