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- September 3, 2010 |
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"Glucose Targets in and Around Pregnancy: How Low Can You Go? Part I"Dr. David McIntyre (biography)
English - 2005-06-15 - 31 minutes
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Summary :
In this presentation Dr. McIntyre discusses several aspects of importance to diabetes care in pre-pregnancy and early pregnancy.
Teratogenesis or fetal anomalies in diabetes are related to a number of metabolic disturbances including hyperglycaemia (1), and studies have shown an increased risk of fetal malformations in type 1 and type 2 diabetic women with even slightly raised HbA1c during early pregnancy (2,3). There is evidence to suggest that in utero exposure to hyperglycaemia predisposes to childhood obesity, IGT and type 2 diabetes (4-8), and it remains to be seen whether tight glycaemic control could reduce this risk.
Dr. McIntyre presents Australian data on glycaemic control in diabetic patients from the ANDIAB survey, and discusses recommendations and guidelines for diabetes treatment before and during pregnancy from the National Diabetes in Pregnancy Advisory Committee (NDiPAC), the Australasian Diabetes in Pregnancy Society (ADIPS) and the American Diabetes Association, with some closing comments on steps that can be taken to improve pre-pregnancy glycaemic control.
Copyright © 2005 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Diabetes and teratogenesis
- Glycaemic control in Australian diabetics
- NDiPAC consensus statement and ADIPS guidelines concerning diabetes treatment before and during pregnancy
- Action to improve pre-pregnancy glycaemic control
Bibliographic references :
1. Reece EA, Homko CJ."Why do diabetic women deliver malformed infants?" Clin Obstet Gynecol. 2000 Mar;43(1):32-45.
2. L. Suhonen, V. Hiilesmaa, K. Teramo. Glycaemic control during early pregnancy and fetal malformations in women with Type I diabetes mellitus Diabetologia. 2000;43(1):79 - 82.
3. Towner D, Kjos SL, Leung B, Montoro MM, Xiang A, Mestman JH, Buchanan TA.Congenital malformations in pregnancies complicated by NIDDM.Diabetes Care. 1995 Nov;18(11):1446-51.
4. A. Plagemann A, T. Harder A, R. Kohlhoff A, W. Rohde A, G. Dörner. Glucose tolerance and insulin secretion in children of mothers with pregestational IDDM or gestational diabetes Diabetologia. 1997;40(9):1094 - 1100.
5. Plagemann A, Harder T, Kohlhoff R, Rohde W, Dorner G.Overweight and obesity in infants of mothers with long-term insulin-dependent diabetes or gestational diabetes. Int J Obes Relat Metab Disord. 1997 Jun;21(6):451-6.
6. Silverman BL, Rizzo TA, Cho NH, Metzger BE. Long-term effects of the intrauterine environment. The Northwestern University Diabetes in Pregnancy Center.
Diabetes Care. 1998 Aug;21 Suppl 2:B142-9.
7. Eugène Sobngwi MD, Philippe Boudou PhD, Franck Mauvais-Jarvis MD, Hervé Leblanc MD, Gilberto Velho MD, Patrick Vexiau MD, Raphaël Porcher PhD, Samy Hadjadj MD, Richard Pratley MD, P Antonio Tataranni MD, Fabien Calvo MD and DrJean-François Gautier MD. Effect of a diabetic environment in utero on predisposition to type 2 diabetes The Lancet. Volume 361, Issue 9372 , 31 May 2003, Pages 1861-1865.
8. Dabelea D, Knowler WC, Pettitt DJ. Effect of diabetes in pregnancy on offspring: follow-up research in the Pima Indians.J Matern Fetal Med. 2000 Jan-Feb;9(1):83-8.
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