| Hypoglycaemia during pregnancy in women with Type 1 diabetes. | |
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MedLine Citation:
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PMID: 22313112 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Aims: To explore incidence, risk factors, possible pathophysiological factors and clinical management of hypoglycaemia during pregnancy in women with Type 1 diabetes. Methods: Literature review. Results: In women with Type 1 diabetes, severe hypoglycaemia occurs three to five times more frequently in early pregnancy than in the period prior to pregnancy, whereas in the third trimester the incidence of severe hypoglycaemia is lower than in the year preceding pregnancy. The frequency distribution of severe hypoglycaemia is much skewed, as 10% of the pregnant women account for 60% of all recorded events. Risk factors for severe hypoglycaemia during pregnancy include a history with severe hypoglycaemia in the year preceding pregnancy, impaired hypoglycaemia awareness, long duration of diabetes, low HbA(1c) in early pregnancy, fluctuating plasma glucose values (≤ 3.9 mmol/l or ≥ 10.0 mmol/l) and excessive use of supplementary insulin injections between meals. Pregnancy-induced nausea and vomiting seem not to be contributing factors. Conclusions: Striving for near-normoglycaemia with focus on reduction of plasma glucose fluctuations during pregnancy should have high priority among clinicians with the persistent aim of improving pregnancy outcome among women with Type 1 diabetes. Pre-conception counselling, carbohydrate counting, use of insulin analogues, continuous subcutaneous insulin infusion (insulin pump) therapy and real-time continuous glucose monitoring with alarms for low glucose values might be relevant tools to obtain near-normoglycaemia without episodes of severe hypoglycaemia. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK. |
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Authors:
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L Ringholm; U Pedersen-Bjergaard; B Thorsteinsson; P Damm; E R Mathiesen |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-7 |
Journal Detail:
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Title: Diabetic medicine : a journal of the British Diabetic Association Volume: - ISSN: 1464-5491 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8500858 Medline TA: Diabet Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK. |
Affiliation:
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Center for Pregnant Women with Diabetes, Rigshospitalet, University of Copenhagen, 2Department of Endocrinology, Rigshospitalet, Copenhagen Endocrinology Section, Department of Cardiology, Nephrology and Endocrinology, Hillerød Hospital, Hillerød Faculty of Health Sciences, University of Copenhagen and 5Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark. |
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