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Type 2 Diabetes in Pregnancy.

Anil Kapur1, Harold David McIntyre2, Moshe Hod3

  • 1World Diabetes Foundation, 30 A, Krogshoejvej, Bagsverd 2880, Denmark; FIGO Pregnancy and NCD Committee, Jabotinski Street, Petah Tiqwa 49100, Israel.

Endocrinology and Metabolism Clinics of North America
|July 27, 2019
PubMed
Summary
This summary is machine-generated.

Pregnancy-induced insulin resistance and underlying defects worsen hyperglycemia. Maternal type 2 diabetes (DM) increases risks for offspring, highlighting the need for preconception care.

Keywords:
ManagementPregnancy hyperglycemiaType 2 diabetes

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Perinatology

Background:

  • Pregnancy involves significant metabolic adaptations that increase insulin resistance.
  • Preexisting insulin resistance, compounded by pregnancy-induced changes, can lead to hyperglycemia.
  • Pancreatic beta-cell dysfunction exacerbates hyperglycemia in susceptible individuals during pregnancy.

Purpose of the Study:

  • To examine the impact of hyperglycemia in pregnancy, particularly in women with type 2 diabetes mellitus (DM).
  • To assess the risks associated with maternal type 2 DM for pregnancy outcomes and offspring health.
  • To emphasize the importance of preconception care for metabolic control in women with type 2 DM.

Main Methods:

  • Review of metabolic adaptations during pregnancy.
  • Analysis of pregnancy outcomes in women with type 2 DM compared to general population.
  • Evaluation of risks conferred by in utero exposure to type 2 DM.

Main Results:

  • Women with type 2 DM face elevated risks of major congenital malformations, stillbirth, and neonatal mortality.
  • Perinatal mortality risk is significantly higher in pregnancies complicated by type 2 DM.
  • In utero exposure to type 2 DM increases offspring's risk and hastens its development.

Conclusions:

  • Maternal hyperglycemia during pregnancy, especially from type 2 DM, poses substantial risks to both mother and fetus.
  • Preconception care is crucial for optimizing metabolic control in women with type 2 DM before pregnancy.
  • Early intervention and management are vital to mitigate adverse outcomes associated with type 2 DM in pregnancy.