Abstract
Type 1 diabetes (T1DM) is an autoimmune disease characterized by the gradual loss of β-cell function and insulin secretion. In pregnant women with T1DM, endogenous insulin production is absent or minimal, and exogenous insulin is required to control glycemia and prevent ketoacidosis. During pregnancy, there is a partial decrease in the activity of the immune system, and there is a suppression of autoimmune diseases. These changes in pregnant women with T1DM are reflected by Langerhans islet enlargement and improved function compared to pre-pregnancy conditions. N-3 polyunsaturated fatty acids (n-3 PUFA) have a protective effect, affect β-cell preservation, and increase endogenous insulin production. Increased endogenous insulin production results in reduced daily insulin doses, better metabolic control, and adverse effects of insulin therapy, primarily hypoglycemia. Hypoglycemia affects most pregnant women with T1DM and is several times more common than that outside of pregnancy. Strict glycemic control improves the outcome of pregnancy but increases the risk of hypoglycemia and causes maternal complications, including coma and convulsions. The suppression of the immune system during pregnancy increases the concentration of C-peptide in women with T1DM, and n-3 PUFA supplements serve as the additional support for a rise in C-peptide levels through its anti-inflammatory action.
Highlights
Since ALA and LA compete for crucial enzymes involved in fatty acid metabolism and conversion to pro-inflammatory or anti-inflammatory eicosanoids, it is important to investigate the effect of co-intake of n-3 and n-6 polyunsaturated fatty acids (PUFA) [36]
The C-peptide concentration gradually increases during pregnancy, independent of blood glucose concentration, in pregnant women suffering from type 1 diabetes mellitus [29,38]
Continuous glucose monitoring (CGM) is a method of continuous monitoring of glucose levels in interstitial fluid which was coined for improving metabolic control and expected result of glycemic monitoring is a reduction in hyperglycemia and a reduction in low glucose levels including symptomatic hypoglycemia [7,44]
Summary
Type 1 diabetes is a condition caused by autoimmune damage to the insulin-producing β-cells of the pancreatic islets, usually leading to severe endogenous insulin deficiency [1]. The goal of treating women with type 1 diabetes who plan a pregnancy is to achieve optimal glycemic control before and during pregnancy in order to reduce the incidence of miscarriage, congenital malformations, macrosomia, and neonatal complications. Pharmaceutics 2021, 13, 2082 metabolic control in pregnant women with type 1 diabetes mellitus is associated with an increased risk of miscarriage, preeclampsia, congenital malformations, asphyxia, macrosomia, and perinatal morbidity and mortality [4,5,6]. Intensive glycemic control improves pregnancy outcomes; it increases the risk of hypoglycemia [8,9]women and causes complications, including coma, is convulsions, The goal of treating withmaternal type 1 diabetes who plan a pregnancy to achieve and death [10]. Several times more common than that outside of pregnancy [11,12]
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