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[Diabetes and pregnancy].

U M Schäfer-Graf1, K Vetter

  • 1Abteilung für Geburtsmedizin, Krankenhaus Neukölln, Berlin.

Therapeutische Umschau. Revue Therapeutique
|November 5, 1999
PubMed
Summary

Managing diabetes during pregnancy is crucial for preventing fetal complications like macrosomia and neonatal hypoglycemia. Preconception counseling and tight glucose control are vital for women with type-I diabetes, while diet and exercise manage gestational diabetes.

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Perinatology

Context:

  • Pregnancy involves two main forms of disturbed carbohydrate metabolism: pre-existing type-I diabetes (0.8% incidence) and gestational diabetes (3-5% incidence).
  • Maternal hyperglycemia leads to fetal hyperinsulinism, resulting in significant offspring complications.

Purpose:

  • To outline the risks associated with diabetes in pregnancy, including fetal macrosomia, intrauterine death, and neonatal morbidity.
  • To emphasize the importance of preconception counseling, optimized glucose control, and multidisciplinary management for diabetic pregnancies.

Summary:

  • Pre-existing type-I diabetes and gestational diabetes pose risks due to maternal hyperglycemia and fetal hyperinsulinism.
  • Complications include fetal macrosomia, intrauterine death, neonatal hypoglycemia, and delayed organ maturation.
  • Management involves preconception care, strict glucose control, and collaborative efforts between obstetricians and diabetologists.

Impact:

  • Optimizing glucose control preconceptionally reduces abortion and congenital anomaly rates in offspring of mothers with type-I diabetes.
  • Effective management strategies are essential for improving maternal and fetal outcomes in diabetic pregnancies.
  • Postnatal screening and counseling are recommended for women with gestational diabetes due to their increased future diabetes risk.

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