Development of early-onset type 2 diabetes in the young: implications for child bearing

The prevalence of type 2 diabetes mellitus is increasing in children and adolescents worldwide, particularly among minority youth. This has led to an increase in the number of pregnancies complicated by type 2 diabetes, which has now exceeded pregnancies complicated by type 1 diabetes. Although the data are somewhat limited, those studies that are available seem to indicate that the rate of adverse maternal and fetal outcomes is at least as great, if not greater, for type 2 as for type 1 diabetes. It has been postulated that some of the excess risk is due to the fact that women with type 2 diabetes are older, heavier, less likely to seek early prenatal care, and are generally in less satisfactory glycemic control. This article reviews the existing data on pregnancies complicated by type 2 diabetes and the implications for management and prevention.