Prevalence, antihypertensive strategy, and pregnancy outcome

OBJECTIVEdTo evaluate the prevalence of diabetic nephropathy and microalbuminuria in pregnant women with type 2 diabetes in comparison with type 1 diabetes and to describe pregnancy outcomes in these women following the same antihypertensive protocol. RESEARCH DESIGN ANDMETHODSdAmong 220 women with type 2 diabetes and 445 women with type 1 diabetes giving birth from 2007–2012, 41 women had diabetic ne-phropathy (albumin-creatinine ratio$300mg/g) ormicroalbuminuria (albumin-creatinine ratio 30–299 mg/g) in early pregnancy. Antihypertensive therapy was initiated if blood pressure $135/85 mmHg or albumin-creatinine ratio $300 mg/g. RESULTSdThe prevalence of diabetic nephropathywas 2.3 % (5 of 220) in womenwith type 2 diabetes and 2.5 % (11 of 445) in women with type 1 diabetes (P = 1.00). The figures for micro-albuminuria were 4.5 (10 of 220) vs. 3.4 % (15 of 445) (P = 0.39). Baseline glycemic control was comparable between women with type 2 diabetes (n = 15) and type 1 diabetes (n = 26). Blood pressure at baseline was median 128 (range 100–164)/81 (68–91) vs. 132 (100–176)/80 (63– 100) mmHg (not significant) and antihypertensive therapy in type 2 versus type 1 diabetes was used in 0 and 62%, respectively, at baseline, increasing to 33 and 96%, respectively, in lat