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Diabetes in Pregnancy

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Principles of Diabetes Mellitus

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Abstract

Diabetes complicates 4% of all pregnancies is the United States and is a significant cause of maternal and fetal morbidity.1 The majority (88%) of diabetes cases in pregnancy are due to gestational diabetes which is associated with increased BMI and increased age. The remaining 12% are due to type 1 and type 2 diabetes, often referred to as pregestational diabetes. Patients with gestational diabetes usually develop hyperglycemia during the second half of pregnancy. Hyperglycemia at this stage of gestation clearly causes fetal macrosomia and neonatal hypoglycemia. Patients with pregestational diabetes are at risk for hyperglycemia early in pregnancy; this hyperglycemia is associated with significantly increased rates of fetal loss and fetal malformation. The evidence that has accrued over the past twenty years reveals that tight glycemic control can prevent most of the maternal and fetal complications of diabetes. The neonatal death rate in pregnancies complicated by diabetes was 50% prior to the introduction of insulin, 10% in 1939 after the introduction of insulin, and approached that in non-diabetic pregnancies by the 1980s.2

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Authors
  1. Adina E. Schneider
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  2. Elliot J. Rayfield
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Editors and Affiliations

  1. Division of Endocrinology, Beth Israel Medical Center, New York, New York, USA

    Leonid Poretsky M.D. (Chief, Professor of Medicine) (Chief, Professor of Medicine)

  2. Albert Einstein College of Medicine, New York, New York, USA

    Leonid Poretsky M.D. (Chief, Professor of Medicine) (Chief, Professor of Medicine)

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Schneider, A.E., Rayfield, E.J. (2004). Diabetes in Pregnancy. In: Poretsky, L. (eds) Principles of Diabetes Mellitus. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6260-0_12

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  • DOI: https://doi.org/10.1007/978-1-4757-6260-0_12

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-6262-4

  • Online ISBN: 978-1-4757-6260-0

  • eBook Packages: Springer Book Archive

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