10 Years Later... Diabetes Mellitus and Pregnancy

摘要

The past 10 years have seen an incredible increase in the number of people with type 2 diabetes mellitus. Pregnancy is no exception, and the alarming rates of diabetes in pregnancy continue to rise. However, the last decade has also seen extraordinary gains, as both our understanding and treatment of this disease have improved dramatically. Although advances have been made in all aspects of diabetes and pregnancy, this article will focus on gestational diabetes (GDM), which currently affects up to 14% of all pregnancies. Research has continued to show that maintaining euglycemia during pregnancy reduces and can even eliminate the risk for GDM complications, such as fetal macro-somia, stillbirth, and congenital malformations. Additionally, normalizing glycemic levels during pregnancy can reduce the risk of offspring of diabetic mothers (ODM) becoming obese and having type 2 diabetes early in life. Although disputed by some, the most compelling data shows maintaining glucose levels that mimic nondiabetic pregnancies results in fewer maternal complications and improves fetal outcome. With the acceptance of postprandial blood glucose levels as the standard indicator for GDM risk, broader prenatal screening, and the use of insulin analogues in pregnancy, glucose control is improving and more women with gestational diabetes are having healthy babies.