Type 2 diabetes in pregnancy - An increasing problem.
The worldwide epidemic in type 2 diabetes has been associated with an increased diagnosis in young adults. This has lead to a rapid rise in the number of pregnancies complicated by type 2 diabetes. Studies have shown risk of serious adverse outcome, including congenital malformation and perinatal mortality, is the same, or increased, in type 2 diabetes compared to type 1 diabetes. Despite improved glycaemic control in type 2 diabetes compared to type 1 diabetes, rates of perinatal morbidity, including preterm birth and macrosomia, appear to be similar. Risk factors associated with poor pregnancy outcome in women with type 2 diabetes include obesity, ethnicity and poor pregnancy preparation. This review will cover practical aspects of management of type 2 diabetes before, during and after pregnancy, including prepregnancy care, safety of oral hypoglycaemic agents, glycaemic management during labour, and choice of effective contraception.
Temple
Rosemary
R
Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, Norwich, Norfolk, United Kingdom. rosemary.temple@nnuh.nhs.uk
Murphy
Helen
H
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001942:Breast Feeding; D000013:Congenital Abnormalities / Q000517:prevention & control; D003267:Contraception; D003927:Diet, Diabetic; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007743:Labor, Obstetric; D009765:Obesity / Q000150:complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000453:epidemiology* / Q000208:ethnology
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D005492:Folic Acid