Gutaj P, et al. - The risk factors for preeclampsia (PE) in women with type 1 diabetes (T1DM) were determined in this study. In women with type 1 diabetes, primiparity and diabetic vasculopathy appeared to be the strongest risk factors for PE. Though, preexisting hypertension and higher gestational weight gain (GWG) were also correlated with PE in these women. In all 3 trimesters, higher glycated hemoglobin (HbA_1c) and triglycerides (TG) levels were correlated with PE among laboratory outcomes. They recommended further study to examine the association between higher IR and PE in women with T1DM.

• The clinicians performed a prospective, nested case–control study on a population of 165 women with T1DM.
• They divided women into 3 subgroups: normotensive (N = 141), gestational hypertension (GH) (N = 8), and PE (N = 16).
• They collected clinical data in the first trimester (< 12th week), in mid-pregnancy (20–24th weeks), and just prior to delivery (34–39th weeks).
• They quantified IR in the first trimester using the estimated glucose disposal rate formula (eGDR, milligrams/kilogram/minute).
• They used simple logistic regression to search for factors associated with PE and GH.
• Multiple logistic regression with stepwise selection was used for multivariate comparisons.

• The clinicians diagnosed all preeclampsia cases in primiparae.
• The strongest determinant of PE was the presence of vasculopathy (OR 10.8, 95% CI 3.27–35.97, P = 0.0001), followed by a history of chronic hypertension (6.05, 1.75–20.8, P = 0.004) and the duration of diabetes (1.11, 1.03–1.12, P = 0.009).
• However, after adjustment for the presence of vasculopathy, chronic hypertension and duration of diabetes were no longer associated with PE.
• Higher gestational weight gain (GWG) was correlated with PE.
• And, this association remained significant after adjustment for first trimester body mass index (1.14, 1.02–1.28, P = 0.02).
• Both systolic and diastolic blood pressure evaluated in the first trimester were significant determinants of PE.
• Though, this association was no longer observed after adjustment for the presence of chronic hypertension.
• From all 3 trimesters, glycated hemoglobin (HbA_1c) levels were significantly associated with PE (first trimester: 1.38, 1.01–1.87, P = 0.04; second trimester: 2.76, 1.43–5.31, P = 0.002; third trimester: 2.42, 1.30–4.51, P = 0.005).
• A negative association was found between eGDR and PE (0.66, 0.50–0.87, P = 0.003).
• Triglycerides (TG) in all 3 trimesters were positively associated with PE among lipids
• This association was independent of HbA_1c levels (first trimester: 5.32, 1.65–17.18, P = 0.005; second trimester: 2.52, 1.02–6.26, P = 0.05; third trimester: 2.28, 1.39–3.74, P = 0.001.
• In the regression analysis, they did not find any predictors of GH among all analyzed factors.