Chapter

Pregestational (type 1 and type 2) diabetes: care and complications during pregnancy

Helen R Murphy

in Diabetes in Pregnancy

Published on behalf of Oxford University Press

ISBN: 9780199593033
Published online January 2012 | e-ISBN: 9780191730771 | DOI: http://dx.doi.org/10.1093/med/9780199593033.003.0017

Series: Oxford Diabetes Library

Pregestational (type 1 and type 2) diabetes: care and complications during pregnancy

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• Fetal growth acceleration resulting in the delivery of a large for gestational age or macrosomic infant is the commonest complication of pregnancy affecting approximately 50% of diabetic pregnancies • Macrosomic infants are at increased risk both of immediate birth complications (shoulder dystocia, neonatal hypoglycaemia and neonatal care admission) and of longer term complications (insulin resistance, obesity and type 2 diabetes) • Pre-eclampsia complicates 13% or 1 in 7 diabetes pregnancies and is closely related to glycaemic control during the second trimester • Quick acting analogues (NovoRapid® and Humalog®) are the preferred prandial insulins. Basal insulin replacement is controversial with NICE recommending only Neutral Protamine Hagedorn (NPH) or pump therapy during pregnancy.

Chapter.  3843 words.  Illustrated.

Subjects: Endocrinology and Diabetes

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