Optimization of insulin therapy in a pregnant woman with concomitant type 1 diabetes mellitus and a single kidney

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Abstract

Relevance: Many women with type 1 diabetes mellitus (DM) are concerned about complications they experienced in previous pregnancies and they want to avoid these complications in future since it is impossible to control the level of glycemia when it goes beyond the target value and there is a need to achieve the optimal glycemic level.

Case report: At 36 weeks of pregnancy a patient urgently presented to the emergency department of the Clinical Hospital "Mother and Child Tyumen" complaining of the absence of fetal movement for 12 hours and uncontrolled hyperglycemia (11–12 mmol/L according to the MiniLink monitor). The woman underwent emergency cesarean section due to the signs of fetal hypoxia, the presence of the uterine scar, type I diabetes in the stage of decompensation, diabetic nephropathy, vicar hypertrophy of the single kidney. The woman was discharged home on the 5th day from the moment of childbirth, the child was discharged from the neonatal pathology department on the 8th day in a satisfactory condition.

Conclusion: The use of modern technologies in the treatment of type 1 diabetes during pregnancy including an automated insulin delivery system demonstrates promising methods of treating this complication and enables a woman to carry and give birth to a living and healthy child.

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About the authors

Valentina V. Khasanova

Tyumen State Medical University, Ministry of Health of Russia; Clinical Hospital "Mother and Child Tyumen"

Author for correspondence.
Email: malofeeva-vv@yandex.ru
ORCID iD: 0000-0002-3764-5086

PhD, Associate Professor at the Department of Obstetrics, Gynecology and Perinatology of the Institute of Motherhood and Childhood; Head of Maternity Department

Russian Federation, Tyumen; Tyumen

Tatiana A. Yerbaktanova

Clinical Hospital "Mother and Child Tyumen"

Email: 72@mcclinics.ru

PhD, Chief Physician

Russian Federation, Tyumen

Elena G. Yakubova

Tyumen State Medical University, Ministry of Health of Russia; Clinical Hospital "Mother and Child Tyumen"

Email: yakubova-eg@yandex.ru
ORCID iD: 0000-0001-7201-600X

PhD, Associate Professor at the Department of Obstetrics, Gynecology and Perinatology of the Institute of Motherhood and Childhood

Russian Federation, Tyumen; Tyumen

Tatiana P. Shevlyukova

Tyumen State Medical University, Ministry of Health of Russia

Email: tata21.01@mail.ru
ORCID iD: 0000-0002-7019-6630

Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology of the Institute of Motherhood and Childhood

Russian Federation, Tyumen

Oksana A. Arabaji

Tyumen State Medical University, Ministry of Health of Russia; Clinical Hospital "Mother and Child Tyumen"

Email: malofeeva-vv@yandex.ru

PhD, Associate Professor at the Department of Obstetrics and Gynecology of the Institute of Motherhood and Childhood; Head of the Women's Health Clinic

Russian Federation, Tyumen; Tyumen

Maxim S. Shvedsky

Tyumen State Medical University, Ministry of Health of Russia

Email: malofeeva-vv@yandex.ru

6th-year student of the Institute of Clinical Medicine

Russian Federation, Tyumen

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