Differences in Cardiovascular Risk Factors and Glycemic Control in Women with Type 1 Diabetes based on Parity
Zeisel, Amanda   (University of Colorado at Denver and Health Sciences Center)
Mentor: Sippl, Rachel (University of Colorado)
Women with type 1 diabetes (T1D) are at an increased risk of developing coronary artery disease (CAD). Additionally, women who have pregnancies complicated by adverse cardiovascular outcomes increase the risk for premature CAD in women later in life. However, it is currently unknown how extreme glucose variability experienced in uncomplicated pregnancies impact CAD risk for women with T1D. This study aims to compare cardiovascular risk factors (weight, blood pressure, dyslipidemia) and glycemic control (hemoglobin A1c) between women who have had children and nulliparous women with T1D through a retrospective chart review. Women with confirmed T1D were placed in three groups: complicated-women who experienced pregnancies complicated by adverse cardiovascular outcomes, uncomplicated-women whose pregnancies were not complicated by adverse cardiovascular outcomes, and controls-nulliparous women. The groups were frequency matched based on age, duration of diabetes, and BMI. Women in the complicated group had a significant drop in HDL after pregnancy while those in the uncomplicated and control groups experienced no significant changed in HDL. The complicated group also had a significantly higher post-delivery diastolic blood pressure when compared to controls. Both the uncomplicated and complicated groups had significantly higher systolic blood pressure post delivery when compared to controls. Finally, the complicated group had a clinically (but not statistically) significant 0.46 decrease in A1c following pregnancy. This data suggests that hypertensive complications in pregnancy lead to a lowering of HDL. It also suggests potentially greater glucose variability in women with complicated pregnancies verse uncomplicated pregnancies. This also illustrates a lasting increase in blood pressure following any pregnancy. Next steps to confirm and build on these findings will be to increase the time window for data collection both before and after pregnancy and to invite subjects identified by this chart review to be part of a clinical study where arterial stiffness between parous and nulliparous women with T1D will be measured and compared over time.