Type 1 Diabetes in Pregnancy
Congenital malformations and perinatal mortality rates remain severalfold higher in pregnant women with type 1 diabetes than in the background population, and still only a minority of women plan their pregnancy. Optimizing glycemic control is the accepted goal, but remains challenging, and must be constantly balanced against the risks of hypoglycemia. Recent advances including Continuous Glucose Monitoring Systems, Continuous Subcutaneous Insulin Infusion, Closed Loop Devices and very Fast Acting Insulin Aspart analogs offer new possibilities to increase glucose time in target in selected, motivated patients, however their relative roles and indication for use require further elucidation. The importance of education cannot be overstated.
CONCLUSION: Because the predictive accuracy of ultrasound prediction of birth weight improves with gestational age, fetal growth assessment at term is recommended to aid with delivery planning in women with diabetes. PMID: 31405599 [PubMed - as supplied by publisher]
Abstract OBJECTIVE: Continuous glucose monitoring tends to replace capillary blood glucose (CBG) self-monitoring. Our aim was to determine the agreement between CBG and a flash glucose monitoring system (Flash-GMS) in treatment decision-making during pregnancy. RESEARCH DESIGN AND METHODS: Insulin-treated women with either type 1 (n = 25), type 2 (n = 4) or gestational diabetes (n = 4) were included. A Flash-GMS sensor was applied for 14 days. Women scanned the sensor whenever they wished to monitor their CBG. The primary endpoint was the proportion of discordant therapeutic decisions they would have made bas...
AbstractPurpose of ReviewDiabetes affects an increasing number of pregnancies. Regular exercise is recommended for pregnant women without diabetes, but whether exercise during pregnancy also benefits women with gestational diabetes (GDM) or preexisting (type 1 or type 2) diabetes or if these women have any specific risks is unclear.Recent FindingsRecent evidence suggests that low- to moderate-intensity exercise improves blood glucose and may delay insulin initiation for women with GDM. Exercise is also safe, with no reports of increased maternal or neonatal complications. Few studies evaluated exercise as adjunct therapy f...
Scientists at the University of Glasgow found type 2 diabetes poses a bigger risk for unborn babies than type 1, which is significantly less common. Around four million people in the UK have diabetes.
Publication date: Available online 19 July 2019Source: Canadian Journal of DiabetesAuthor(s): P. Khanna, L. Chow, E. Brydges, K. Anukum, S. Liu, J.L. Mahon, T. Joy, R. McManusAbstractPregnancies complicated by diabetes are increasingly frequent. The Endocrine and Pregnancy Clinic [EPC] at St Joseph’s Health Care London is the stable, local provider of all outpatient pregnancy diabetes care, thereby providing an opportunity to document patient characteristics with time.MethodsEPC charts were reviewed for: 2000-2002; 2010-2012; 2014-2016 documenting DM type (T1DM, T2DM, GDM); age; weight; year/week of DM diagnosis; med...
Conclusions/interpretationMaternal obesity is associated with increased incidence of type 2 diabetes in the offspring. Evidence-based strategies that reduce obesity among women of reproductive age and that might reduce the incidence of diabetes in their offspring are urgently required.
The relationship between type 1 diabetes in pregnancy and adverse neonatal outcomes is well known [1 –3]. It is therefore recommended that all women of childbearing age with type 1 diabetes plan pregnancy in order to achieve optimal glycaemic control, evaluate diabetes-related complications and refresh their knowledge and skills about diabetes[4,5]. Prepregnancy care (PPC) has been associated wit h an 80% reduction of serious adverse pregnancy outcomes (major congenital malformation, stillbirth or neonatal death) and lower rates of very premature delivery[6–9].
CONCLUSION: Pregnancy provides an important opportunity for health professionals to educate and support women with pre-pregnancy diabetes about their breastfeeding intentions. PMID: 31239238 [PubMed - as supplied by publisher]
Breastfeeding has significant health benefits for maternal and infant health, yet women with pre-pregnancy diabetes (type 1 or type 2 diabetes mellitus) are often less likely to breastfeed compared with other childbearing women.
ConclusionThis case highlights that fulminant type 1 diabetes in pregnancy may be associated with Coxsackievirus B1 infection.