diabetes in pregnancy

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I need a word document on diabetes in pregnancy

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DIABETES MELLITUS & PREGNANCY
Definitions
 Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variable
degree with onset or first recognition during pregnancy.
 The above definition applies regardless of whether insulin or only diet modification is
used for treatment or whether the condition continues after pregnancy
Epidemiology
 Abnormal maternal glucose regulation occurs in 3-10% of pregnancies
 Studies suggest that the prevalence of diabetes mellitus (DM) among women of
childbearing age is increasing in the United States.
 This increase is believed to be attributable to more sedentary lifestyles, changes in
diet, continued immigration from high-risk populations, and the virtual epidemic of
childhood and adolescent obesity that is presently evolving in United States.
 Gestational diabetes mellitus accounts for 90% of cases of diabetes mellitus in
pregnancy.
 Type II diabetes mellitus accounts for 8% of cases of diabetes mellitus in pregnancy,
and given its increasing incidence, preexisting diabetes mellitus now affects 1% of
pregnancies
 Preexisting diabetes (i.e. diabetes diagnosed prior to pregnancy) affects
approximately 1-3 pregnancies per 1000 births.
 GDM complicates approximately 4% of pregnancies
 Infants of mothers with preexisting diabetes experience double the risk of serious
injury at birth, triple the likelihood of cesarean delivery, and quadruple the incidence
of newborn intensive care unit admission.
 Studies indicate that the risk of these morbidities is directly proportional to the degree
of maternal hyperglycemia.
 For this reason, the excessive fetal and neonatal morbidity attributable to diabetes in
pregnancy should be considered preventable with early diagnosis and effective
treatment therapies
 A study reported in 2007 has demonstrated and increased incidence of gestational
diabetes mellitus in women receiving prophylactic 17 alpha-hydroxyprogesterone
caproate for the prevention of recurrent preterm delivery (from 4.9% in control to
12.9% in treated patients).
Physiology
 Deterioration of glucose tolerance occurs normally during pregnancy.
 Significant metabolic changes are necessary to provide proper energy delivery to the
growing conceptus.
 Hormones associated with pregnancy such as human placental lactogen (HPL) and
cortisol lower glucose levels, promote fat deposition, and stimulate appetite.

 Rising serum levels of estrogen and progesterone i...


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