Relationship Between Pre-eclampsia & Type 1 Diabetes

Type 1 diabetes is a medical condition when your pancreas doesn’t make the sufficient quantity of insulin that is needed by your body. This is a very big problem as insulin is the hormone that is required for cells to absorb sugar and convert it to energy. While type 2 diabetes is mainly caused by lifestyle habits and diet, type 1 diabetes is genetic.

As your body doesn’t have enough insulin, your blood sugar rises and may lead to severe complications. This increases manifold if you are pregnant as there is a higher risk of pre-eclampsia in diabetes that might lead to preterm delivery, fetal growth restrictions, cardiac and renal malformation, and other conditions.

Pre-eclampsia is a serious obstetrical condition that is characterized by gestational hypertension with new onset of proteinuria in the 20th week of pregnancy. Considered the number one cause of fetal morbidity and mortality, diabetes and preeclampsia is bad news.

In this article, we will talk more about the relationship between preeclampsia and type 1 diabetes. Read on to learn more.

Prevalence of Pre-eclampsia With Type 1 Diabetes

As per studies, around 15-20% of pregnant women who are type 1 diabetic get pre-eclampsia. The risk of developing pre-eclampsia is two to four times more likely in women with type 1 or type 2 diabetes.

Women with type 1 diabetes and a history of pre-eclampsia are also associated with an increased risk of retinopathy and nephropathy (1).

Causes of Pre-eclampsia in Women With Type 1 Diabetes

Type 1 diabetes is characterized by high blood sugar levels due to a lack of insulin. It causes oxidative stress, dyslipidemia, and often high body weight. All these together can affect the cells of the blood vessels, causing pre-eclampsia.

Hyperglycemia

Type 1 diabetes greatly raises pre-eclampsia risks because of the higher levels of sugar in the blood (hyperglycemia). High sugar is associated with structural and functional changes in large arteries that cause endothelial (lining of blood vessels) dysfunction, narrowing of the arteries, and arterial stiffness (2). As the blood supply to every part reduces, the heart is forced to pump faster, which causes blood pressure to rise.

Oxidative Stress

Increased levels of glucose produce free radicals that damage the endothelial layer of the arteries (3).

Dyslipidaemia

This causes damage to the endothelial layer by messing up the vasomotor activity of the endothelial cells (4).

Obesity

Obesity is a shared risk factor between the two.

Common Symptoms of Pre-eclampsia

Pre-eclampsia is important to recognize and treat due to adverse outcomes of non-treatment, including fetal demise and maternal end-organ damage.

Common symptoms include (5):

• Proteinuria (excess protein in the urine)
• Increased liver enzymes
• Severe headaches
• Blurred vision accompanied with or without vision sensitivity
• Dark spots appearing in your vision
• Swelling of hands and face
• Shortness of breath
• Nausea
• Vomiting
• Right upper quadrant abdominal pain

Severe pre-eclampsia symptoms include:

• Decreased kidney or liver function
• Fluid in the lungs
• Decreased urination
• Thrombocytopenia (the platelet levels in the blood are lower, which can cause unstoppable bleeding)
• Vaginal bleeding

Diagnosis & Treatment of Pre-eclampsia

Diagnosis

Timely diagnosis is essential when you have pre-eclampsia for proper intervention (6). It is diagnosed when you have:

• High blood pressure above 140/90 (mild pre-eclampsia) and 160/110 (severe preeclampsia) on two occasions at least 6 hours apart.
• A low blood platelet count
• Excess protein in the urine.
• Fluid in the lungs (pulmonary edema).
• Recurrent headaches accompanied by blurred vision.

Other serum biomarkers for preeclampsia diagnosis are:

• Soluble FMS-like tyrosine kinase 1
• Placental growth factor (PIGF)
• Asymmetric Dimethyl Arginine (ADMA)
• Placental protein 13
• P-Selectin
• Soluble Endoglin (sEng)

Treatment

Treatment of pre-eclampsia is primarily to manage the condition as much as possible. Various diabetes management solutions can help manage fluctuating blood sugar levels, and practicing a healthy lifestyle can help you keep your diabetes under control. Brisk walking, yoga, and water workouts are some of the safe exercises for diabetes while pregnant.

If it isn’t very severe, medication can help. Your doctor might recommend:

• Antihypertensive drugs to lower the blood pressure
• Anticonvulsant medications to prevent seizures
• Corticosteroids for women at 22-34 weeks of gestation to support fetal lung development

If medicines aren’t able to control the situation, your obstetrician might recommend preterm delivery any time after your 37th week of gestation. With severe pre-eclampsia, your doctor may go for preterm delivery before the 37th week, depending on the condition of the baby.

The risk of pre-eclampsia may be reduced with supplements such as:

• Calcium
• Vitamin D3
• Folic acid
• Vitamin B6
• Vitamin C
• Vitamin E
• Magnesium
• Coenzyme Q10

Certain herbs have also been known to be effective in pre-eclampsia and other birth-related complications. They are hawthorn berries, cramp bark, and milk thistle that come in capsules, powders, tinctures, and even tea.

Medical Disclaimer

Dario Health offers health, fitness, and nutritional information and is designed for educational purposes only and should not be relied upon. The information provided might not be accurate, full, complete, or effective. Accordingly, it is not intended to be used for medical diagnosis or treatment or as a substitute for professional medical advice. You are strongly advised to consult your physician or qualified health professional regarding your condition and appropriate medical treatment. Individual symptoms, situations, and circumstances may vary.

Resources

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4317712/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2350146/
3. https://pubmed.ncbi.nlm.nih.gov/21512515/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126197/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046127/
6. https://wfmchealth.org/maternity-health-care/what-to-know-about-pre-eclampsia-and-gestational-diabetes/

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