Case 06 (2025): A case of pregnancy complicated by type 1 diabetes with severe diabetic nephropathy and retinopathy
10.3760/cma.j.cn113903-20240611-00435
- VernacularTitle:病例06（2025）：妊娠合并1型糖尿病并发严重肾病及视网膜病变1例
- Author:
Hongli HUANG
1
;
Huixia YANG
;
Geng SONG
;
Shuxian WANG
;
Ye FENG
;
Yumei WEI
;
Yu SUN
;
Sufang SHI
;
Xiaoyong YUAN
;
Jing ZHANG
Author Information
1. 北京大学第一医院妇产生殖医学中心，北京 100034
- Publication Type:Journal Article
- Keywords:
Type 1 diabetes mellitus;
Diabetic nephropathy;
Diabetic retinopathy;
Hypertension;
Pregnancy
- From:
Chinese Journal of Perinatal Medicine
2025;28(1):51-56
- CountryChina
- Language:Chinese
-
Abstract:
This paper reported a type 1 diabetes patient who had severe diabetic nephropathy, retinopathy, hypertension, and hypothyroidism before pregnancy. The patient's blood glucose control was poor before pregnancy, and the complications were not properly treated. This was an unintended pregnancy, with a pre-pregnancy glycated hemoglobin A1c of 7.8% and early pregnancy urine protein of 3.81-4.53 g/24 h. Considering the patient's poor blood glucose control before pregnancy and the lack of proper treatment for multiple complications including nephropathy, a multidisciplinary consultation at an external hospital recommended termination of the pregnancy. However, the patient was determined to continue the pregnancy and was referred to Peking University First Hospital. Through strict blood glucose control, monitoring and evaluation of complications, and comprehensive management, the patient's blood glucose and blood pressure were well controlled during pregnancy. Regular monitoring of urine protein, renal function, and ocular fundus was conducted. At 31 weeks and 4 days of gestation, the patient's 24-hour urine protein significantly increased. After promoting fetal lung maturity, a cesarean section was performed at 34 weeks and 1 day of gestation, resulting in a successful delivery with good maternal and neonatal outcomes. At the 42-day postpartum follow-up, the patient's blood glucose and blood pressure were stable, urine protein returned to pre-pregnancy levels, and the infant was in good general condition.
