Any chronic extragenital diseases are always a threat of occurrence of various adverse effects during pregnancy for both the mother and the unborn child. Carbohydrate metabolism disorders that occur during pregnancy are divided into two large groups: pre-gestational diabetes mellitus (PSHD) and gestational diabetes mellitus (GDM). According to the etiological classification of diabetes mellitus, the first group includes type 1 diabetes, type 2 diabetes and other types of diabetes detected before pregnancy, and the second – GDM itself [1].
Type 1 diabetes belongs to the group of the most dangerous chronic diseases for pregnant women. Before the widespread introduction of insulin into clinical practice, pregnancy in women suffering from type 1 diabetes was a rare occurrence and was usually accompanied by high maternal (up to 44%) and perinatal (up to 60%) mortality.
Nowadays, due to the improvement of the quality of the diabetic service, the widespread introduction of intensified insulin therapy, as well as the expansion of diagnostic and therapeutic opportunities in obstetrics, the maternal mortality of patients with diabetes does not differ from that in the general population.
However, perinatal mortality in pregnancies complicated by type 1 diabetes remains extremely high and, according to various authors, ranges from 3 to 15%, and pregnancy and childbirth in women suffering from PSHD are still at high risk. With type 1 diabetes, the risk of spontaneous abortion (CA), congenital malformations (CMD) in the fetus, progression of vascular complications of diabetes in pregnant women, diabetic ketoacidosis, severe hypoglycemia, development of diabetic fetopathy (DF), gestosis of the second half of pregnancy, and urinary tract infections increases , polyhydramnios, delivery by cesarean section, premature birth.
Does this mean that women with type 1 diabetes should not have children? Of course not. Studies convincingly prove that ensuring stable compensation of diabetes not only dramatically reduces the risk of any consequences, but in most patients it can be completely avoided. Therefore, the main task of endocrinologists and obstetricians should be to ensure stable compensation of carbohydrate metabolism at all stages of fetal development – from conception to birth.