ADIPS position paper on pre-existing diabetes and pregnancy

Victoria L Rudland1,2, Sarah A L Price3,4,5,6, Leonie Callaway7,8,9,10

  • 1Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, NSW, Australia.

Insights

This summary outlines the 2020 Australasian Diabetes in Pregnancy Society (ADIPS) guidelines for managing pre-existing type 1 and type 2 diabetes during pregnancy. It covers essential preconception, pregnancy, and postpartum care for optimal maternal and infant outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Maternal-Fetal Medicine

Background:

  • Pre-existing diabetes (type 1 and type 2) complicates pregnancies, requiring specialized management.
  • The Australasian Diabetes in Pregnancy Society (ADIPS) provides evidence-based guidelines for optimal care.

Purpose of the Study:

  • To summarize the key clinical practice points from the ADIPS 2020 guideline for pre-existing diabetes in pregnancy.
  • To provide accessible information on preconception, antepartum, intrapartum, and postpartum care.

Main Methods:

  • This is an executive summary of the official ADIPS 2020 guideline.
  • Focuses on clinical practice recommendations for managing diabetes in pregnancy.

Main Results:

  • Key management strategies for type 1 and type 2 diabetes before, during, and after pregnancy are detailed.
  • Guideline emphasizes a multidisciplinary approach to care.

Conclusions:

  • Adherence to the ADIPS 2020 guidelines is crucial for improving outcomes in pregnancies with pre-existing diabetes.
  • Comprehensive care throughout the pregnancy continuum is recommended.

Related Concept Videos

Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.0K
Pathophysiology of Diabetes01:20

Pathophysiology of Diabetes

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
2.7K
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
1.7K
Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
4.5K
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
487
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
417