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Chapter 58 - Pregestational Type 2 Diabetes Mellitus

from Section 10 - Endocrine Disorders in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Amira El-Messidi ,
Melissa-Rosina Pasqua  and
Natasha Garfield
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

A 37-year-old G1P1 with a three-year history of type 2 diabetes mellitus (T2DM) is referred by her primary care provider to your high-risk obstetrics clinic for preconception counseling. Six years ago, she delivered her son at another hospital center.

Keywords

Type II diabetes mellitus, pregestationalPreconception counselingInvestigationsComorbiditiesPharmacology, treatment, antihyperglycemicsLifestyle modifications, nonpharmacologic intervention, exercise benefitsPerinatal risks, complications, maternal-fetal morbidity, adverse outcomePeterson ‘hyperglycemia-hyperinsulinemia’ hypothesisFetal glucose steal syndromeAntepartum, intrapartum, postpartum managementFetal pulmonary corticosteroids, maternal insulin adjustmentObstetric delivery considerationsBreastfeedingContraception
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 744 - 760
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins – Obstetrics. ACOG Practice Bulletin No. 201: pregestational diabetes mellitus. Obstet Gynecol. 2018;132(6):e228–e248.CrossRefGoogle Scholar
American Diabetes Association. 14. Management of diabetes in pregnancy: standards of medical care in diabetes – 2021. Diabetes Care. 2021;44(Suppl 1):S200–S210.Google Scholar
Alexopoulos, AS, Blair, R, Peters, AL. Management of preexisting diabetes in pregnancy: a review. JAMA. 2019;321(18):1811–1819.Google Scholar
(a)Berger, H, Gagnon, R, Sermer, M. Guideline No. 393 – diabetes in pregnancy. J Obstet Gynaecol Can. 2019;41(12):1814–1825. [Correction in J Obstet Gynaecol Can. 2020 Oct;42(10):1288]CrossRefGoogle ScholarPubMed
Diabetes Canada Clinical Practice Guidelines Expert Committee, Feig, DS, Berger, H, et al. Diabetes and pregnancy. Can J Diabetes. 2018;42(Suppl 1):S255–S282. [Correction in Can J Diabetes. 2018 Jun;42(3):337]CrossRefGoogle ScholarPubMed
Egan, AM, Dow, ML, Vella, A. A review of the pathophysiology and management of diabetes in pregnancy. Mayo Clin Proc. 2020;95(12):2734–2746.CrossRefGoogle ScholarPubMed
Hameed, AB, Combs, CA. Society for Maternal-Fetal Medicine Special Statement: updated checklist for antepartum care of pregestational diabetes mellitus. Am J Obstet Gynecol. 2020;223(5):B2–B5.CrossRefGoogle Scholar
Kapur, A, McIntyre, HD, Hod, M. Type 2 diabetes in pregnancy. Endocrinol Metab Clin North Am. 2019;48(3):511–531.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (NICE). Diabetes in pregnancy: management from preconception to the postnatal period; NICE guideline. February 25, 2015. Available at www.nice.org.uk/guidance/ng3. Accessed July 18, 2021.Google Scholar
Scottish Intercollegiate Guidelines Network (SIGN). Management of diabetes, a national clinical guideline. March 2010, updates November 2017. Available at www.sign.ac.uk/assets/sign116.pdf. Accessed July 18, 2021.Google Scholar

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