Document Detail

Medical care of pregnant women with type 1 diabetes - current guidelines and clinical practice.
MedLine Citation:
PMID:  23344642     Owner:  NLM     Status:  Publisher    
The prevalence of all types of diabetes mellitus is increasing worldwide. Diabetes is a common metabolic complication of pregnancy. For many years, pregnancy complicated by type 1 diabetes mellitus (T1DM) was associated with particularly poor prognosis and while this has changed dramatically over last two decades, a lot has yet to be done. The continuous relationship between the maternal glucose level and prevalence of pregnancy complications was described. The list of outcomes includes congenital malformations, stillbirths, neonatal mortality, macrosomia, hypoglycemia and many others. Several new therapeutic and monitoring tools have become available over recent years, including short and long-acting insulin analogs, personal pumps, and continuous glucose monitoring systems. Interestingly, pregnancy planning and preconceptional education turned out to be particularly effective in improving glycemic control in T1DM women and achieving therapeutic goals recommended by clinical guidelines. This resulted in the reduction of some maternal and neonatal pregnancy outcomes reported from various populations. Despite of this progress, the prevalence of the most common complication, neonatal macrosomia, is still substantially higher than in newborns of mothers without diabetes. The likely causes of this phenomenon are short episodes of hyperglycemia, particularly postprandial ones, liberal diet, maternal obesity and weight gain during pregnancy. These potential reasons should be adequately addressed in clinical practice. In the future, new therapeutic devices, such as close-loop insulin pumps, may help to further improve the prognosis in pregnancy complicated by T1DM.
Katarzyna Cyganek; Tomasz Klupa; Magdalena Szopa; Barbara Katra; Maciej T Małecki
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-23
Journal Detail:
Title:  Polskie Archiwum Medycyny Wewnetrznej     Volume:  -     ISSN:  1897-9483     ISO Abbreviation:  Pol. Arch. Med. Wewn.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401225     Medline TA:  Pol Arch Med Wewn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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