Type 2 diabetes in pregnancy: exposing deceptive appearances.
Now that we have been forewarned of the growing pandemic of type 2 diabetes and obesity in pregnancy, we need to become forearmed. Over the past few decades there has been no significant improvement in perinatal outcome complicated by diabetes mellitus (type 1 and type 2). The recognition of modifiable risk factors such as maternal glycemic control using self-monitoring blood glucose in combination with pharmacological therapy (intensified therapy) and weight gain in pregnancy should enhance pregnancy outcome. The overemphasis and concentration on the non-modifiable risk factors in pregnancy is a futile pursuit that may generate lively discussion but paucity of results. The focus needs to be in education for the care provider, i.e., enhanced recognition of this growing entity and a heightened awareness of the need for pre-pregnancy counseling about preconception glycemic control. Another center of attention should be the dissemination of information to patients of the impending maternal and fetal risks of type 2 diabetes in pregnancy. This care would include antenatal care for surveillance of maternal diabetes complications as well as careful obstetric surveillance to improve maternal and fetal outcomes.
Langer
Oded
O
Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center, Columbia University, New York, NY 10019, USA. odlanger@chpnet.org
D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D016742:Preconception Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000188:drug therapy*; D011295:Prenatal Care
D007004:Hypoglycemic Agents